Provider Demographics
NPI:1871725747
Name:COMSTOCK, DANA KAY
Entity type:Individual
Prefix:MS
First Name:DANA
Middle Name:KAY
Last Name:COMSTOCK
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 1:2111 W CHURCHILL ST
Mailing Address - Street 2:UNIT 209
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-5534
Mailing Address - Country:US
Mailing Address - Phone:773-251-4156
Mailing Address - Fax:773-235-3380
Practice Address - Street 1:2111 W CHURCHILL ST
Practice Address - Street 2:UNIT 209
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-5534
Practice Address - Country:US
Practice Address - Phone:773-251-4156
Practice Address - Fax:773-235-3380
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-11
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist