Provider Demographics
NPI:1962523019
Name:BURTON, DONNA S (MHS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:DONNA
Middle Name:S
Last Name:BURTON
Suffix:
Gender:F
Credentials:MHS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8131 W ROSEBURY DR
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-2402
Mailing Address - Country:US
Mailing Address - Phone:815-735-8850
Mailing Address - Fax:
Practice Address - Street 1:8131 W ROSEBURY DR
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-2402
Practice Address - Country:US
Practice Address - Phone:815-735-8850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist