Individual
ELIN N KUZMACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2171 W EXECUTIVE DR STE 500, ADDISON, IL 60101-5626
(630) 766-0505
Mailing address
2171 W EXECUTIVE DR STE 500, ADDISON, IL 60101-5626
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
242.005650
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1285731547
CPT
IL
Enumeration date
09/26/2019
Last updated
09/26/2019
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