Provider Demographics
NPI:1427790229
Name:OSTROWSKI, ALYSSA MARY (CCC-SLP)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:MARY
Last Name:OSTROWSKI
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1366 N MILL CT
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60074-7078
Mailing Address - Country:US
Mailing Address - Phone:224-456-7910
Mailing Address - Fax:
Practice Address - Street 1:1095 PINGREE RD STE 209
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-1727
Practice Address - Country:US
Practice Address - Phone:847-458-8890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-12
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
IL146.016578235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty