Carol Stout
Individual provider Active NPI Speech-Language Pathologist · Cairo, IL
NPI 1669984399 · NPPES record last updated Nov 3, 2017
Key facts
- NPI
- 1669984399
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 146.003302 (IL)
- Practice address
- 3101 Elm St
Cairo, IL 62914-1362 - Phone
- (618) 734-1027
- NPI assigned
- Nov 3, 2017
- 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)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146.003302 | IL | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 146.003302 | IL | Yes |
Addresses
Primary practice location
3101 Elm St
Cairo, IL 62914-1362
Mailing address
3101 Elm St
Cairo, IL 62914-1362
Phone (618) 734-1027
Other providers in Cairo, IL
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- Southernmost Illinois Community Health Improvement Corporation
- Southernmost Illinois Community Health Improvement Corporation
- Southernmost Illinois Community Health Improvement Corporation
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- Bernard Williams
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All providers in Cairo, 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 Nov 3, 2017. 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.