Provider Demographics
NPI:1033556915
Name:KORZUN, LEAH R (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:R
Last Name:KORZUN
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:MISS
Other - First Name:LEAH
Other - Middle Name:R
Other - Last Name:WITKOV
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CC-SLP
Mailing Address - Street 1:6719 MEADOWCREST DR
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60516-3526
Mailing Address - Country:US
Mailing Address - Phone:630-542-0213
Mailing Address - Fax:
Practice Address - Street 1:333 N PARK RD
Practice Address - Street 2:
Practice Address - City:LA GRANGE PARK
Practice Address - State:IL
Practice Address - Zip Code:60526-1802
Practice Address - Country:US
Practice Address - Phone:708-482-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-31
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242002290235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist