Kyla Nikol Bunch, M.S., CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Addison, IL
NPI 1003381179 · NPPES record last updated Oct 4, 2018
Key facts
- NPI
- 1003381179
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 146.013426 (IL)
- Practice address
- 2171 W Executive Dr
Addison, IL 60101-5625 - Phone
- (630) 766-0505
- NPI assigned
- Oct 4, 2018
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Qualified Speech Language Pathologist
- Education
- Other, 2015
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
7125 Janes Ave
Suite 300
Woodridge, IL 60517-2304
9237 S Saint Louis Ave
Evergreen Park, IL 60805-1561
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250911003051 | IL | Practitioner - Qualified Speech Language Pathologist | 6002319480 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146.013426 | IL | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cortlyn Therapy, PC | Speech-Language Pathologist | Current |
Accepting new patients |
Locations
28100 Torch Pkwy
Ste 600
Warrenville, IL 60555
Phone (630) 250-4576
7125 Janes Ave
Ste 300
Woodridge, IL 60517
Phone (630) 413-5817
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 146.013426 | IL | Yes |
Addresses
Primary practice location
2171 W Executive Dr
Addison, IL 60101-5625
Mailing address
1224 W 72ND PL
Chicago, IL 60636-4124
Phone (773) 895-5113
Other providers in Addison, IL
- Miguel Angel Briones
- Broadway Medical Care SC
- Merrick Jay Bromberg
- Jonathan Wiley Brown
- Edward Daniel Buck
- Tresa Burda
- Mary Rae Butler
- Steve P. Butzon
- Elizabeth A Byrnes
- Cristina Cabrera
All providers in Addison, 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 Oct 4, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.