Individual provider Active NPI

Courtney Kimberly Huellen, CCC-SLP/L

  • Speech-Language Pathologist
  • Lake in the Hills, IL
National Provider Identifier
1700539848
Registry record updated Jan 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146.015946 Issued in IL
Practice address
5494 McKenzie Dr
Lake in the Hills, IL 60156-6290
Phone
(815) 354-7530
NPI assigned
Jan 29, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 146.015946 IL Primary

Addresses

Primary practice location

5494 McKenzie Dr
Lake in the Hills, IL 60156-6290

Mailing address

5494 McKenzie Dr
Lake in the Hills, IL 60156-6290
Phone (815) 354-7530

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
146.015946ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1643414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643414400000",
    "number": "1700539848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5494 MCKENZIE DR",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601566290",
            "telephone_number": "815-354-7530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5494 MCKENZIE DR",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601566290",
            "telephone_number": "815-354-7530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUELLEN",
        "first_name": "COURTNEY",
        "middle_name": "KIMBERLY",
        "credential": "CCC-SLP/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-29",
        "last_updated": "2022-01-29",
        "certification_date": "2022-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.015946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake in the Hills, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2022; 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.