Provider Demographics
NPI:1003212218
Name:GARTLAN, DANA LYNN (MS CCC-SLP)
Entity type:Individual
Prefix:MISS
First Name:DANA
Middle Name:LYNN
Last Name:GARTLAN
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1601 S HALSTED ST
Mailing Address - Street 2:APT 205
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60608-4455
Mailing Address - Country:US
Mailing Address - Phone:708-250-5414
Mailing Address - Fax:888-977-1739
Practice Address - Street 1:1601 S HALSTED ST
Practice Address - Street 2:APT 205
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60608-4455
Practice Address - Country:US
Practice Address - Phone:708-250-5414
Practice Address - Fax:888-977-1739
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-16
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146011997235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist