Provider Demographics
NPI:1700034865
Name:OSTRANDER, JENNIE LYNN (MA)
Entity Type:Individual
Prefix:MS
First Name:JENNIE
Middle Name:LYNN
Last Name:OSTRANDER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 SURRYSE RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:LAKE ZURICH
Mailing Address - State:IL
Mailing Address - Zip Code:60047-3217
Mailing Address - Country:US
Mailing Address - Phone:847-842-4057
Mailing Address - Fax:847-842-4059
Practice Address - Street 1:350 SURRYSE RD
Practice Address - Street 2:SUITE 250
Practice Address - City:LAKE ZURICH
Practice Address - State:IL
Practice Address - Zip Code:60047-3217
Practice Address - Country:US
Practice Address - Phone:847-842-4057
Practice Address - Fax:847-842-4059
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242000868235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist