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NPI Code Detail

MEDICARE: DEBORAH KUSHNER KROSNICK SLP-CCC

MEDICARE: DEBORAH KUSHNER KROSNICK SLP-CCC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist146.004993IL

General Provider Information

NPI Number : 1568720365
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBORAH KUSHNER KROSNICK SLP-CCC
Provider Business Mailing Address
First Line : 1520 CHAPEL CT
Second Line :
City : DEERFIELD
State : IL
Zip : 60015-2213
Country : US
Telephone Number : 847-940-8216
Fax Number :
Provider Business Practice Location Address
First Line : 1520 CHAPEL CT
Second Line :
City : DEERFIELD
State : IL
Zip : 60015-2213
Country : US
Telephone Number : 847-940-8216
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/30/2012
Last Update Date : 04/30/2012

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