Lindsey Coburn

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146013877 Issued in IL

Practice address

18160 W Gages Lake Rd
Gages Lake, IL 60030-1819

Phone

(847) 548-8470

Fax

(847) 548-8471

NPI assigned

Nov 13, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Spec Educ Dist Lake Co Sedol

  • Local Education Agency (LEA)
  • Gages Lake, IL
  • NPI 1013046614
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1510531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510531200000",
    "number": "1043723109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2417 TRAILSIDE LN",
            "city": "WAUCONDA",
            "state": "IL",
            "postal_code": "600845016",
            "telephone_number": "602-621-0306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18160 W GAGES LAKE RD",
            "city": "GAGES LAKE",
            "state": "IL",
            "postal_code": "600301819",
            "telephone_number": "847-548-8470",
            "fax_number": "847-548-8471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COBURN",
        "first_name": "LINDSEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-13",
        "last_updated": "2017-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146013877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Activelife Therapy LLC
• Courtney Bestler
• Payton Rianne Estep, M.S. CCC-SLP
• Ann Gear
• Sarah Hilton
• Danielle Izzo
• Laurie Johansen

• Speech-Language Pathologist in Gages Lake, IL
• Providers in Gages Lake, IL by specialty
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.