Provider Demographics
NPI:1174633259
Name:SINGAVI, KUSHALRAJ P (MS)
Entity Type:Individual
Prefix:MR
First Name:KUSHALRAJ
Middle Name:P
Last Name:SINGAVI
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2814 STACIA CT
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60431-9218
Mailing Address - Country:US
Mailing Address - Phone:815-690-2100
Mailing Address - Fax:815-254-8267
Practice Address - Street 1:2814 STACIA CT
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60431-9218
Practice Address - Country:US
Practice Address - Phone:815-690-2100
Practice Address - Fax:815-254-8267
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146005049235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist