Individual provider Active NPI

Lindsay Diekhoff, SLP

  • Speech-Language Pathologist
  • Pekin, IL
National Provider Identifier
1265773774
Registry record updated Aug 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146008274 Issued in IL
Practice address
2988 Court St
Pekin, IL 61554-6229
Phone
(309) 353-5940
Fax
(309) 353-1654
NPI assigned
Mar 7, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 146008274 IL Primary

Addresses

Primary practice location

2988 Court St
Pekin, IL 61554-6229

Mailing address

275 S University St
Normal, IL 61761
Phone (309) 438-8641

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190808001393 IL Practitioner - Qualified Speech Language Pathologist 8527395961 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois State University CurrentSince Aug 19, 2019 Accepting new patients
Brendon J Johnson, OD, PC Past Accepting new patients
Professional Therapy Services, Inc Speech-Language Pathologist PastSince Aug 1, 2012 Accepting new patients

Locations

4720 Campus
Normal, IL 61790

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1362614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564617600000",
    "number": "1265773774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 S UNIVERSITY ST",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "61761",
            "telephone_number": "309-438-8641",
            "fax_number": "309-438-0575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2988 COURT ST",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615546229",
            "telephone_number": "309-353-5940",
            "fax_number": "309-353-1654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEKHOFF",
        "first_name": "LINDSAY",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-07",
        "last_updated": "2019-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146008274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pekin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.