Provider Demographics
NPI:1639707730
Name:DONZAL, DEANA LYNN (LCPC)
Entity Type:Individual
Prefix:MISS
First Name:DEANA
Middle Name:LYNN
Last Name:DONZAL
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7732 NEWLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:IL
Mailing Address - Zip Code:60459-1018
Mailing Address - Country:US
Mailing Address - Phone:773-680-4011
Mailing Address - Fax:
Practice Address - Street 1:1400 E IRVING PARK RD
Practice Address - Street 2:
Practice Address - City:STREAMWOOD
Practice Address - State:IL
Practice Address - Zip Code:60107-3201
Practice Address - Country:US
Practice Address - Phone:630-540-3923
Practice Address - Fax:630-540-3927
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-01
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180012872101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty