Annie Lietz
Individual provider Active NPI Speech-Language Pathologist · Hoyleton, IL
NPI 1649948712 · NPPES record last updated Feb 7, 2022
Key facts
- NPI
- 1649948712
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- Practice address
- 22741 Sassafras Rd
Hoyleton, IL 62803-1324 - Phone
- (618) 322-6879
- NPI assigned
- Sep 2, 2021
- 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)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | Yes |
Addresses
Primary practice location
22741 Sassafras Rd
Hoyleton, IL 62803-1324
Mailing address
22741 Sassafras Rd
Hoyleton, IL 62803-1324
Phone (618) 322-6879
Other practice location 1
2122 Troy Rd Ste 120
Edwardsville, IL 62025-2540
Phone (618) 800-4620
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Health Information Exchange (HIE) |
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- Megan Elizabeth Kasten
- Kelly Sue Melton
- Denise L Orrill
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- Tamara Sadler
All providers in Hoyleton, 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 Feb 7, 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.