Provider Demographics
NPI:1659495034
Name:PURISKI, CORINNE ANN (MS,CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:CORINNE
Middle Name:ANN
Last Name:PURISKI
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:MRS
Other - First Name:CORINNE
Other - Middle Name:ANN
Other - Last Name:PURISKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS,CCC-SLP
Mailing Address - Street 1:24118 S INDIAN TRL
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:IL
Mailing Address - Zip Code:60442-8435
Mailing Address - Country:US
Mailing Address - Phone:815-478-0471
Mailing Address - Fax:815-478-0481
Practice Address - Street 1:350 HOUBOLT RD
Practice Address - Street 2:SUITE 101
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60431-8305
Practice Address - Country:US
Practice Address - Phone:815-725-9992
Practice Address - Fax:815-725-9993
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
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