Provider Demographics
NPI:1134639289
Name:OSTHOFF, ANNE MARGARET (MS)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:MARGARET
Last Name:OSTHOFF
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 N GRAHAM ST
Mailing Address - Street 2:
Mailing Address - City:SULLIVAN
Mailing Address - State:IL
Mailing Address - Zip Code:61951-1114
Mailing Address - Country:US
Mailing Address - Phone:217-728-2321
Mailing Address - Fax:217-728-4399
Practice Address - Street 1:910 N GRAHAM ST
Practice Address - Street 2:
Practice Address - City:SULLIVAN
Practice Address - State:IL
Practice Address - Zip Code:61951-1114
Practice Address - Country:US
Practice Address - Phone:217-728-2321
Practice Address - Fax:217-728-4399
Is Sole Proprietor?:No
Enumeration Date:2017-10-03
Last Update Date:2017-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.005587235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist