Sue Ann Blankenship
Individual provider Active NPI Speech-Language Pathologist · Normal, IL
NPI 1194243063 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1194243063
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 146001634 (IL)
- Practice address
- 919 S Linden St
Normal, IL 61761-3730 - Phone
- (309) 454-8646
- NPI assigned
- Aug 31, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 146001634 | IL | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 146001634 | IL | Yes |
Addresses
Primary practice location
919 S Linden St
Normal, IL 61761-3730
Mailing address
919 S Linden St
Normal, IL 61761-3730
Phone (309) 454-8646
Other providers in Normal, IL
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- Robin Billingsley
- Dena Binegar
- Bailey A Birditt
- Tyler Curtis Bishop
- Alexa Blatt
- Mackenzie Blomquist
- Bloomington Heart Institute
- Bloomington Normal Healthcare, LLC
- Bloomington Normal Public Transportation System
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 Jul 21, 2022. 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.