Provider Demographics
NPI:1992922207
Name:KNEZZ, ROSARIO O
Entity type:Individual
Prefix:MRS
First Name:ROSARIO
Middle Name:O
Last Name:KNEZZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 BRIARCLIFF DR
Mailing Address - Street 2:
Mailing Address - City:NEW LENOX
Mailing Address - State:IL
Mailing Address - Zip Code:60451-2657
Mailing Address - Country:US
Mailing Address - Phone:815-485-1594
Mailing Address - Fax:
Practice Address - Street 1:1401 BRIARCLIFF DR
Practice Address - Street 2:
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-2657
Practice Address - Country:US
Practice Address - Phone:815-485-1594
Practice Address - Fax:815-485-1594
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant