Kimberly L Hall, MS CCC/SLP

Individual provider Active NPI Speech-Language Pathologist · Danforth, IL

NPI 1154848174 · NPPES record last updated Aug 18, 2023

Key facts

NPI
1154848174
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
146.009968 (IL)
Practice address
101 Locust St.
Danforth, IL 60930
Phone
(815) 269-2230
NPI assigned
Aug 30, 2017
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
146.009968ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Cissna Park Community Unit School District # 6 Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 146.009968 IL Yes

Addresses

Primary practice location

101 Locust St.
Danforth, IL 60930

Mailing address

106 E Front St
Gilman, IL 60938-1331
Phone (815) 683-2662

Other practice location 1

511 N 2nd St
Cissna Park, IL 60924-9734
Phone (815) 457-2171

Other providers in Danforth, IL

All providers in Danforth, IL · Speech-Language Pathologist in Illinois

Sources for this page

Verify at the official NPI Registry.