Individual
DANAI C.F FANNIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, M.A., SLP
Contact information
Practice address
3100 SYCAMORE RD, DEKALB, IL 60115-9621
(815) 753-1481
(815) 753-1664
Mailing address
3100 SYCAMORE RD, DEKALB, IL 60115-9621
(815) 753-1481
(815) 753-1664
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146.010950
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
146.010950
IN STATE LICENSE
IN
Enumeration date
04/19/2012
Last updated
04/19/2012
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