Provider Demographics
NPI:1972851541
Name:GRAY, DANIELLE LORI (CCC-SLP/L, CBIS)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:LORI
Last Name:GRAY
Suffix:
Gender:F
Credentials:CCC-SLP/L, CBIS
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:DANIELLE
Other - Last Name:CUNNINGHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP/L, CBIS
Mailing Address - Street 1:17W682 BUTTERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:OAKBROOK TERRACE
Mailing Address - State:IL
Mailing Address - Zip Code:60181
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17W682 BUTTERFIELD RD
Practice Address - Street 2:
Practice Address - City:OAKBROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181
Practice Address - Country:US
Practice Address - Phone:630-909-6559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-29
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242002324235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist