Provider Demographics
NPI:1285756775
Name:TOWLER, DANA (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:TOWLER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4707 PATTY LN
Mailing Address - Street 2:
Mailing Address - City:RINGWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60072-9680
Mailing Address - Country:US
Mailing Address - Phone:815-728-1789
Mailing Address - Fax:
Practice Address - Street 1:5150 NORTHWEST HWY
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-8058
Practice Address - Country:US
Practice Address - Phone:815-455-9800
Practice Address - Fax:815-455-9359
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.006904235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist