Makenzie Alicen Goble, M.S. CF-SLP
Individual provider Active NPI Speech-Language Pathologist · Casey, IL
NPI 1902322076 · NPPES record last updated Aug 20, 2017
Key facts
- NPI
- 1902322076
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 242004407 (IL)
- Practice address
- 100 NE 15TH St
Casey, IL 62420-2152 - Phone
- (217) 932-5217
- NPI assigned
- Aug 20, 2017
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 242004407 | IL | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 242004407 | IL | Yes |
Addresses
Primary practice location
100 NE 15TH St
Casey, IL 62420-2152
Mailing address
7 NE 2ND St
Casey, IL 62420-1628
Phone (618) 302-1400
Other names
- Makenzie Alicen Ward
Other providers in Casey, IL
- Gena Cochonour
- Lyn Michele Cochonour
- Katherine Disch
- Robert Lee Dougherty
- Kristi Esker
- Cory D Hanley
- Heartland Manor Inc Nursing Center
- Heartland Nursing & Rehabilitation LLC
- Carla Sue Honselman
- Karen S Huddlestun
All providers in Casey, 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 Aug 20, 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.