Kimberly Lynn Adelman, M.S.,CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Normal, IL
NPI 1154670461 · NPPES record last updated Aug 31, 2012
Key facts
- NPI
- 1154670461
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 146005149 (IL)
- Practice address
- 275 South University Street
Rachel Cooper
Normal, IL 61761 - Phone
- (309) 438-8641
- Fax
- (309) 438-5221
- NPI assigned
- Aug 31, 2012
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Qualified Speech Language Pathologist
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Illinois State University
Practice addresses (Care Compare)
275 S University
211 Rachel Cooper BLDG
Normal, IL 61761-0001
Phone (309) 438-8641
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161013001476 | IL | Practitioner - Qualified Speech Language Pathologist | 9032407671 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146005149 | IL | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Illinois State University | Current |
Accepting new patients |
Locations
4720 Campus
Normal, IL 61790
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 146005149 | IL | Yes |
Addresses
Primary practice location
275 South University Street
Rachel Cooper
Normal, IL 61761
Mailing address
Eckelman-Taylor Speech and Hearing Clinic
Campus Box 4720
Normal, IL 61790-4720
Phone (309) 438-8641
Other names
- Miss Kimberly Lynn Polony
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All providers in Normal, 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 Aug 31, 2012. 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.