Individual
DOMINIQUE M PANOSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
10124 S KEDZIE AVE, EVERGREEN PARK, IL 60805-3738
(708) 907-7000
Mailing address
8817 S SACRAMENTO AVE, EVERGREEN PARK, IL 60805-1224
(773) 865-0554
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146013108
IL
Other
Enumeration date
02/28/2023
Last updated
02/28/2023
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