Nicole Gayle Kneer, MS CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Villa Grove, IL
NPI 1003066564 · NPPES record last updated Sep 22, 2008
Key facts
- NPI
- 1003066564
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 146.006333 (IL)
- Practice address
- 202 N. Pine St.
Villa Grove, IL 61956-1426 - Phone
- (217) 832-2147
- NPI assigned
- Sep 22, 2008
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146.006333 | IL | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 146.006333 | IL | Yes |
Addresses
Primary practice location
202 N. Pine St.
Villa Grove, IL 61956-1426
Mailing address
202 N. Pine St.
Villa Grove, IL 61956-1426
Other providers in Villa Grove, IL
- Dowler Chiropractic P.C.
- Franklin L Dowler Jr.
- Sara M. Hickey
- Phillip William Robinson Jones
- Nicole Kirkman
- Leon Optometric Clinic PC
- Steve Alan Leon
- Bhargavkumar Patel
- Jessica Pedersen
- Meagan Nicole Quigley
All providers in Villa Grove, IL · Speech-Language Pathologist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 22, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.