Provider Demographics
NPI:1053325977
Name:LAUSCHKE, DONNA M (MA, CCC-A)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:M
Last Name:LAUSCHKE
Suffix:
Gender:F
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3633 W LAKE AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-5805
Mailing Address - Country:US
Mailing Address - Phone:847-729-9122
Mailing Address - Fax:847-729-9134
Practice Address - Street 1:3633 W LAKE AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026-5805
Practice Address - Country:US
Practice Address - Phone:847-729-9122
Practice Address - Fax:847-729-9134
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01615422OtherBCBS
K15637Medicare ID - Type Unspecified