Provider Demographics
NPI:1184041055
Name:KOSZULINSKI, ALISON
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:KOSZULINSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:
Other - Last Name:CRISTELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19625 SILVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60487-7052
Mailing Address - Country:US
Mailing Address - Phone:815-464-7897
Mailing Address - Fax:
Practice Address - Street 1:19625 SILVERSIDE DR
Practice Address - Street 2:
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60487-7052
Practice Address - Country:US
Practice Address - Phone:815-464-7897
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-27
Last Update Date:2014-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242002673235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist