Provider Demographics
NPI:1285668111
Name:YALA, DANA A (CCC-SLP/L)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:A
Last Name:YALA
Suffix:
Gender:F
Credentials:CCC-SLP/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:817 S GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60304-1124
Mailing Address - Country:US
Mailing Address - Phone:708-383-5363
Mailing Address - Fax:708-434-0460
Practice Address - Street 1:817 S GROVE AVE
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60304-1124
Practice Address - Country:US
Practice Address - Phone:708-383-5363
Practice Address - Fax:708-434-0460
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01632134OtherBCBS OF IL PIN #