Lori Rubenacker, MS-CCC/SLP-L

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146005996 Issued in IL

Practice address

1099 N Van St
Olney, IL 62450-3016

Phone

(618) 395-4372

NPI assigned

Jan 19, 2018

Last updated

Jan 19, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1516320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516320000000",
    "number": "1487162871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1099 N VAN ST",
            "city": "OLNEY",
            "state": "IL",
            "postal_code": "624503016",
            "telephone_number": "618-395-4372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1099 N VAN ST",
            "city": "OLNEY",
            "state": "IL",
            "postal_code": "624503016",
            "telephone_number": "618-395-4372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBENACKER",
        "first_name": "LORI",
        "credential": "MS-CCC/SLP-L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-19",
        "last_updated": "2018-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146005996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1528174067",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jazlyn Robinson, MHP
• Antonio Rodriguez
• Vickie Lynn Roeser, PT
• Dirk Rosenberg
• Billy Ross
• Megan Nicole Rule, MPH
• Kelsey Lynn Runyon, PT, DPT
• Emily Garrett Sager, OTR/L
• Michele L Sanford, OT
• Ken Schanda

• Speech-Language Pathologist in Olney, IL
• Providers in Olney, IL by specialty
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.