Provider Demographics
NPI:1730311473
Name:MCDONALD, ALISON LEE (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:LEE
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:LEE
Other - Last Name:BUSH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:427 E INDIANA ST
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-5559
Mailing Address - Country:US
Mailing Address - Phone:630-234-7894
Mailing Address - Fax:
Practice Address - Street 1:427 E INDIANA ST
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-5559
Practice Address - Country:US
Practice Address - Phone:630-234-7894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-13
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.009852235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist