Jennifer L Dahman
Individual provider Active NPI Speech-Language Pathologist · Saint Joseph, IL
NPI 1740414374 · NPPES record last updated May 11, 2009
Key facts
- NPI
- 1740414374
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 146.005846 (IL)
- Practice address
- 1506 E Grand Ave
Saint Joseph, IL 61873-9492 - Phone
- (217) 469-8823
- NPI assigned
- May 11, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 26
Medicare Care Compare profile
- Specialty
- Qualified Speech Language Pathologist
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- The Board of Trustees of the University of Illinois
Practice addresses (Care Compare)
2001 S Oak St
Suite B
Champaign, IL 61820-0912
Phone (217) 333-2205
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240514003236 | IL | Practitioner - Qualified Speech Language Pathologist | 5496196016 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146.005846 | IL | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Board of Trustees of the University of Illinois | Speech-Language Pathologist | Current |
Accepting new patients |
| The Board of Trustees of the University of Illinois | Current | Accepting new patients | |
| The Board of Trustees of the University of Illinois | Current |
Accepting new patients |
Locations
2001 S Oak St
Ste B
Champaign, IL 61820
Phone (217) 244-1806
1640 W Roosevelt Rd
#727
Chicago, IL 60608
Phone (312) 413-1871
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 146.005846 | IL | Yes |
Addresses
Primary practice location
1506 E Grand Ave
Saint Joseph, IL 61873-9492
Mailing address
1506 E Grand Ave
Saint Joseph, IL 61873-9492
Phone (217) 469-8823
Other providers in Saint Joseph, IL
- Melissa Bigger
- Troy Dean Branson
- Andrea Canas
- Christie Clinic, LLC
- Sherdon Wade Cordova
- Edmund R. Rudnicke II, Prof Corp
- Illini Christian Ministries Inc
- Richard Kenneth Ingram
- JMP Counseling and Tutoring Services, LLC
- Leslie Renee Johnson
All providers in Saint Joseph, 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 May 11, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.