Provider Demographics
NPI:1710217583
Name:DOSZAK, ARLENE LOUISE (MA CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:ARLENE
Middle Name:LOUISE
Last Name:DOSZAK
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1017 JOHN ST
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-6819
Mailing Address - Country:US
Mailing Address - Phone:815-727-1556
Mailing Address - Fax:
Practice Address - Street 1:1017 JOHN ST
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-6819
Practice Address - Country:US
Practice Address - Phone:815-727-1556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-30
Last Update Date:2009-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.003211235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist