Provider Demographics
NPI:1548309073
Name:MCDONALD, DANA L (SLP)
Entity type:Individual
Prefix:PROF
First Name:DANA
Middle Name:L
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:L
Other - Last Name:BURLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3312 ELDERBERRY LN
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62711-8288
Mailing Address - Country:US
Mailing Address - Phone:217-546-6046
Mailing Address - Fax:
Practice Address - Street 1:701 N 1ST ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62781-0001
Practice Address - Country:US
Practice Address - Phone:217-788-3300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
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