Provider Demographics
NPI:1770098840
Name:LATHROP, JOEL DANIEL
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:DANIEL
Last Name:LATHROP
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:938 QUEENS LN
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-1940
Mailing Address - Country:US
Mailing Address - Phone:847-730-3179
Mailing Address - Fax:
Practice Address - Street 1:9700 CRAWFORD AVE
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1106
Practice Address - Country:US
Practice Address - Phone:847-676-9380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-11
Last Update Date:2017-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist