Active NPI
Rae Haymond
- Speech-Language Pathologist
- Lake Villa, IL
National Provider Identifier
1093562639
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 242.007154
- Practice address
- 36598 N Wildwood Dr
Lake Villa, IL 60046-9305 - Phone
- (224) 908-9898
- NPI assigned
- May 1, 2024
- Last updated
- Mar 4, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 242.007154 | IL | Primary |
Addresses
Primary practice location
36598 N Wildwood Dr
Lake Villa, IL 60046-9305
Mailing address
36598 N Wildwood Dr
Lake Villa, IL 60046-9305
Phone (224) 908-9898
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 242.007154 | IL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1714521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741046400000",
"number": "1093562639",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "36598 N WILDWOOD DR",
"city": "LAKE VILLA",
"state": "IL",
"postal_code": "600469305",
"telephone_number": "224-908-9898"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "36598 N WILDWOOD DR",
"city": "LAKE VILLA",
"state": "IL",
"postal_code": "600469305",
"telephone_number": "224-908-9898"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAYMOND",
"first_name": "RAE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-05-01",
"last_updated": "2025-03-04",
"certification_date": "2025-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "242.007154",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Villa, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.