Provider Demographics
NPI:1942345681
Name:DILLENBURG, DONNA THERESE (MHS, CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:DONNA
Middle Name:THERESE
Last Name:DILLENBURG
Suffix:
Gender:F
Credentials:MHS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:447 QUASSEY AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE BLUFF
Mailing Address - State:IL
Mailing Address - Zip Code:60044-1738
Mailing Address - Country:US
Mailing Address - Phone:224-544-5421
Mailing Address - Fax:
Practice Address - Street 1:447 QUASSEY AVE
Practice Address - Street 2:
Practice Address - City:LAKE BLUFF
Practice Address - State:IL
Practice Address - Zip Code:60044-1738
Practice Address - Country:US
Practice Address - Phone:224-544-5421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.006134235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist