Provider Demographics
NPI:1306090469
Name:COYNE, JANA (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:JANA
Middle Name:
Last Name:COYNE
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1022 ROBINHOOD LN
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60526-1581
Mailing Address - Country:US
Mailing Address - Phone:708-352-0034
Mailing Address - Fax:
Practice Address - Street 1:1022 ROBINHOOD LN
Practice Address - Street 2:
Practice Address - City:LA GRANGE PARK
Practice Address - State:IL
Practice Address - Zip Code:60526-1581
Practice Address - Country:US
Practice Address - Phone:708-352-0034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-14
Last Update Date:2008-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.006961235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist