Provider Demographics
NPI:1235502170
Name:ALTOSINO, ANNMARIE (MHS)
Entity Type:Individual
Prefix:
First Name:ANNMARIE
Middle Name:
Last Name:ALTOSINO
Suffix:
Gender:F
Credentials:MHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 E WATERSIDE DR UNIT 1007
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-4712
Mailing Address - Country:US
Mailing Address - Phone:312-805-9686
Mailing Address - Fax:
Practice Address - Street 1:450 E WATERSIDE DR UNIT 1007
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-4712
Practice Address - Country:US
Practice Address - Phone:312-805-9686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-31
Last Update Date:2015-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.012656235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist