Provider Demographics
NPI:1114221637
Name:TOPPER, TANYA LOTZOF (MA)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:LOTZOF
Last Name:TOPPER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1429 N WELLS ST
Mailing Address - Street 2:UNIT 502
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-2559
Mailing Address - Country:US
Mailing Address - Phone:847-209-5353
Mailing Address - Fax:
Practice Address - Street 1:1429 N WELLS ST
Practice Address - Street 2:UNIT 502
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610-2559
Practice Address - Country:US
Practice Address - Phone:847-209-5353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-23
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146010960235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist