Basic Information
Provider Information
NPI: 1033558036
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LUEBKE
FirstName: DANIELLE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.S. CF SLP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 815 E IRVING PARK RD
Address2:  
City: STREAMWOOD
State: IL
PostalCode: 601073073
CountryCode: US
TelephoneNumber: 6308375300
FaxNumber: 6302139076
Practice Location
Address1: 815 E IRVING PARK RD
Address2:  
City: STREAMWOOD
State: IL
PostalCode: 601073073
CountryCode: US
TelephoneNumber: 6308375300
FaxNumber: 6302139076
Other Information
ProviderEnumerationDate: 06/24/2013
LastUpdateDate: 06/24/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000X242.002554ILY Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

No ID Information.


Home