Brynn Erin Basinger, SLP
Individual provider Active NPI Speech-Language Pathologist · Marion, IL
NPI 1881947612 · NPPES record last updated Oct 17, 2012
Key facts
- NPI
- 1881947612
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 146010929 (IL)
- Practice address
- 3905 W Ernestine Dr
Suite B
Marion, IL 62959-5800 - Phone
- (618) 993-6237
- Fax
- (618) 997-3529
- NPI assigned
- Oct 17, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146010929 | IL | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Performance Chiropractic of Southern Illinois LLC | Past | Accepting new patients | |
| Occupational Performance and Rehab, PC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 146010929 | IL | Yes |
Addresses
Primary practice location
3905 W Ernestine Dr
Suite B
Marion, IL 62959-5800
Mailing address
3905 W Ernestine Dr
Suite B
Marion, IL 62959-5800
Phone (618) 993-6237
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 146010929 | Other | IL | IL LICENSE |
Other providers in Marion, IL
- Katie Barnett
- Mark Allen Barnett
- Jaxon Barthelme
- Jesseca Barton
- Timothy Charles Barton
- Megan Joy Bates
- Leslie Bauer
- Ray G Bayer
- Aaron Paul Beard
- Hannah Beasley
All providers in Marion, 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 Oct 17, 2012. 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.