Misty Dawn Hopkins, MS-SLP-L
Individual provider Active NPI Speech-Language Pathologist · Lindenhurst, IL
NPI 1104397660 · NPPES record last updated Dec 10, 2018
Key facts
- NPI
- 1104397660
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 146010123 (IL)
- Practice address
- 2400 E Sand Lake Rd
Lindenhurst, IL 60046-9677 - Phone
- (847) 245-8167
- NPI assigned
- Dec 10, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146010123 | IL | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 146010123 | IL | Yes |
Addresses
Primary practice location
2400 E Sand Lake Rd
Lindenhurst, IL 60046-9677
Mailing address
2400 E Sand Lake Rd
Lindenhurst, IL 60046-9677
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 235Z00000X | Medicaid | IL |
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All providers in Lindenhurst, 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 Dec 10, 2018. 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.