Provider Demographics
NPI:1881712495
Name:DAUN, KRISTEN JOYELL (SLP)
Entity type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:JOYELL
Last Name:DAUN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 NORTHSHORE DRIVE
Mailing Address - Street 2:
Mailing Address - City:WAUCONDA
Mailing Address - State:IL
Mailing Address - Zip Code:60084
Mailing Address - Country:US
Mailing Address - Phone:847-487-9831
Mailing Address - Fax:
Practice Address - Street 1:709 NORTHSHORE DR
Practice Address - Street 2:
Practice Address - City:WAUCONDA
Practice Address - State:IL
Practice Address - Zip Code:60084-1374
Practice Address - Country:US
Practice Address - Phone:847-487-9831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL09149617235Z00000X
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL04932249OtherBLUE CROSS BLUE SHIELD OF