Provider Demographics
NPI:1659898674
Name:BUSING, COURTNEY JANE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:COURTNEY
Middle Name:JANE
Last Name:BUSING
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 N LASALLE
Mailing Address - Street 2:APT 903
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610
Mailing Address - Country:US
Mailing Address - Phone:317-363-1149
Mailing Address - Fax:
Practice Address - Street 1:1211 N LASALLE
Practice Address - Street 2:903
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610
Practice Address - Country:US
Practice Address - Phone:317-363-1149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22006656A235Z00000X
IL146014002235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL146014002OtherILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
IN22006656AOtherINDIANA PROFESSIONAL LICENSING AGENCY