Provider Demographics
NPI:1295911048
Name:KOS, DANIELLE COLENE (MS CCC-SLP/L)
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:COLENE
Last Name:KOS
Suffix:
Gender:F
Credentials:MS CCC-SLP/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1340 CHAUSER LN
Mailing Address - Street 2:
Mailing Address - City:WOODRIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60517-7583
Mailing Address - Country:US
Mailing Address - Phone:630-985-5477
Mailing Address - Fax:
Practice Address - Street 1:1340 CHAUSER LN
Practice Address - Street 2:
Practice Address - City:WOODRIDGE
Practice Address - State:IL
Practice Address - Zip Code:60517-7583
Practice Address - Country:US
Practice Address - Phone:630-985-5477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-10
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist