Provider Demographics
NPI:1699928689
Name:HOSTERMAN, JOHN A (PHD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:A
Last Name:HOSTERMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1229 GREEN BAY RD STE B
Mailing Address - Street 2:
Mailing Address - City:WILMETTE
Mailing Address - State:IL
Mailing Address - Zip Code:60091-1679
Mailing Address - Country:US
Mailing Address - Phone:847-256-1290
Mailing Address - Fax:847-256-1290
Practice Address - Street 1:1229 GREEN BAY RD STE B
Practice Address - Street 2:
Practice Address - City:WILMETTE
Practice Address - State:IL
Practice Address - Zip Code:60091-1679
Practice Address - Country:US
Practice Address - Phone:847-256-1290
Practice Address - Fax:847-256-1290
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-04
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist