Provider Demographics
NPI:1568720365
Name:KROSNICK, DEBORAH KUSHNER (SLP-CCC)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:KUSHNER
Last Name:KROSNICK
Suffix:
Gender:F
Credentials:SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 CHAPEL CT
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-2213
Mailing Address - Country:US
Mailing Address - Phone:847-940-8216
Mailing Address - Fax:
Practice Address - Street 1:1520 CHAPEL CT
Practice Address - Street 2:
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-2213
Practice Address - Country:US
Practice Address - Phone:847-940-8216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-30
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.004993235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist