Basic Information
| Provider Information | |||||||||
| NPI: | 1467781765 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MADONIA | ||||||||
| FirstName: | DANA | ||||||||
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| Credential: | M.A., CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 539 W BROMPTON AVE | ||||||||
| Address2: | APT. 3S | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606576408 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8123256217 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3703 W LAKE AVE | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | GLENVIEW | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600261223 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8479981188 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/15/2009 | ||||||||
| LastUpdateDate: | 12/15/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 146.009533 | IL | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.