Sunita Rueb

Individual provider Active NPI Speech-Language Pathologist · Cissna Park, IL

NPI 1467979484 · NPPES record last updated Aug 30, 2017

Key facts

NPI
1467979484
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
146-002915 (IL)
Practice address
511 N 2ND St
Cissna Park, IL 60924-9734
Phone
(815) 457-2171
NPI assigned
Aug 30, 2017
Sex
Female
Sole proprietor
Yes

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

State licenses

LicenseStateTypeSpecialty
146-002915ILMDSpeech-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 146-002915 IL Yes

Addresses

Primary practice location

511 N 2ND St
Cissna Park, IL 60924-9734

Mailing address

100 Miner St
Crescent City, IL 60928-8092
Phone (815) 683-2662

Other providers in Cissna Park, IL

All providers in Cissna Park, IL · Speech-Language Pathologist in Illinois

Sources for this page

Verify at the official NPI Registry.