Individual provider Active NPI

Kim Wedoff

  • Speech-Language Pathologist
  • Dekalb, IL
National Provider Identifier
1457785933
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202012381 Issued in VA
Practice address
3100 Sycamore Rd
Dekalb, IL 60115-9621
Phone
(815) 753-5697
NPI assigned
Sep 3, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2202012381 VA Primary
Speech-Language Pathologist 235Z00000X 7040-154 WI
Speech-Language Pathologist 235Z00000X 146011848 IL

Addresses

Primary practice location

3100 Sycamore Rd
Dekalb, IL 60115-9621

Mailing address

3100 Sycamore Rd
Dekalb, IL 60115-9621
Phone (815) 753-5697

Other names 1

  • Kim Flower Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI, VA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20161004002313 IL Practitioner - Qualified Speech Language Pathologist 1355639519 Reassigns benefits to 2 organizations
I20260401003840 WI Practitioner - Qualified Speech Language Pathologist 1355639519 Reassigns benefits to 1 organization
I20260415002639 VA Practitioner - Qualified Speech Language Pathologist 1355639519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

7600 Chevy Chase Dr
Suite 300
Austin, TX 78752-1503

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2202012381VAMDSpeech-Language Pathologist
7040-154WIMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Illinois University Current Accepting new patients
Northern Illinois University Speech-Language Pathologist Past Accepting new patients

Locations

3100 Sycamore Rd
DeKalb, IL 60115
Phone (815) 752-2675

Organizations & group practices 4

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": "1378166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1457785933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 SYCAMORE RD",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601159621",
            "telephone_number": "815-753-5697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 SYCAMORE RD",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601159621",
            "telephone_number": "815-753-5697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEDOFF",
        "first_name": "KIM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-03",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202012381",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "7040-154",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146011848",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIM",
            "last_name": "FLOWER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dekalb, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.