Provider Demographics
NPI:1093852915
Name:BROWNSTEIN, R. DEDE (MA, CCC-A)
Entity Type:Individual
Prefix:MS
First Name:R.
Middle Name:DEDE
Last Name:BROWNSTEIN
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 1:4200 W. PETERSON AVE.
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646-6052
Mailing Address - Country:US
Mailing Address - Phone:773-777-3277
Mailing Address - Fax:773-777-2878
Practice Address - Street 1:4200 W. PETERSON AVE.
Practice Address - Street 2:SUITE 100
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-6052
Practice Address - Country:US
Practice Address - Phone:773-777-3277
Practice Address - Fax:773-777-2878
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
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
IL971040Medicare ID - Type Unspecified