Provider Demographics
NPI:1457649105
Name:VON DURING, JENNIFER SUZANNE (AUD)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:SUZANNE
Last Name:VON DURING
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:SUZANNE
Other - Last Name:MOSKOP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:501 SKOKIE BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-2808
Mailing Address - Country:US
Mailing Address - Phone:847-504-3300
Mailing Address - Fax:847-504-3305
Practice Address - Street 1:501 SKOKIE BOULEVARD
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-2808
Practice Address - Country:US
Practice Address - Phone:847-504-3300
Practice Address - Fax:847-504-3305
Is Sole Proprietor?:No
Enumeration Date:2011-07-15
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147001392231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist