Provider Demographics
NPI:1154847366
Name:DACHAUER, JOYCE SUSAN
Entity Type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:SUSAN
Last Name:DACHAUER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2009 N. HAVERHILL CC PARK
Mailing Address - Street 2:
Mailing Address - City:NORMAL
Mailing Address - State:IL
Mailing Address - Zip Code:61761
Mailing Address - Country:US
Mailing Address - Phone:309-242-7762
Mailing Address - Fax:
Practice Address - Street 1:805 N. BARNETT ST.
Practice Address - Street 2:
Practice Address - City:LEROY
Practice Address - State:IL
Practice Address - Zip Code:61752
Practice Address - Country:US
Practice Address - Phone:309-962-4771
Practice Address - Fax:309-962-2893
Is Sole Proprietor?:No
Enumeration Date:2017-08-18
Last Update Date:2017-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.004887235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist