Provider Demographics
NPI:1811381478
Name:DRUCKER, JOHANNA FRANCINE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:JOHANNA
Middle Name:FRANCINE
Last Name:DRUCKER
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 1:1717 N DAYTON ST
Mailing Address - Street 2:APT 204
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-5695
Mailing Address - Country:US
Mailing Address - Phone:847-274-0267
Mailing Address - Fax:
Practice Address - Street 1:1422 W WILLOW ST
Practice Address - Street 2:SUITE 101
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60642-8978
Practice Address - Country:US
Practice Address - Phone:312-399-0370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-22
Last Update Date:2015-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.012556235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist