Amy Lynn Yacucci, M.S. CCC-SLP/L

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146.007957 Issued in IL

Practice address

275 Illinois State Univ
211 Rachel Cooper
Normal, IL 61790-0001

Phone

(309) 438-8641

NPI assigned

Aug 4, 2014

Last updated

Aug 4, 2014By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Illinois State University

  dba Speech & Hearing Clinic

  • Audiologist-Hearing Aid Fitter
  • Normal, IL
  • NPI 1669616983
  NPD

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

{
    "created_epoch": "1407110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407110400000",
    "number": "1851700884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3290 TURQUOIS WAY",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617619390",
            "telephone_number": "309-451-0747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 ILLINOIS STATE UNIV",
            "address_2": "211 RACHEL COOPER",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617900001",
            "telephone_number": "309-438-8641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YACUCCI",
        "first_name": "AMY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "M.S. CCC-SLP/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-04",
        "last_updated": "2014-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.007957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Normal, IL
• Providers in Normal, 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 Aug 4, 2014; 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.