Active NPI
Kimberly Erin Soderberg, CF-SLP
- Speech-Language Pathologist
- Aurora, IL
National Provider Identifier
1912523598
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 242.005893
- Practice address
- 452 N Eola Rd Ste a
Aurora, IL 60502-9110 - Phone
- (888) 308-3728
- NPI assigned
- Jun 19, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 242.005893 | IL | Primary |
Addresses
Primary practice location
452 N Eola Rd Ste a
Aurora, IL 60502-9110
Mailing address
W144N9723 Elmwood Dr
Germantown, WI 53022-6609
Phone (262) 385-8074
Other practice location 1
29 Stonehill Rd Unit D
Oswego, IL 60543-9449
Phone (888) 308-3728
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
| License | State | Type | Specialty |
|---|---|---|---|
| 242.005893 | IL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592524800000",
"number": "1912523598",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "W144N9723 ELMWOOD DR",
"city": "GERMANTOWN",
"state": "WI",
"postal_code": "530226609",
"telephone_number": "262-385-8074"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "452 N EOLA RD STE A",
"city": "AURORA",
"state": "IL",
"postal_code": "605029110",
"telephone_number": "888-308-3728"
}
],
"practiceLocations": [
{
"address_1": "29 Stonehill Rd Unit D",
"address_purpose": "LOCATION",
"city": "Oswego",
"state": "IL",
"postal_code": "605439449",
"country_code": "US",
"telephone_number": "888-308-3728",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SODERBERG",
"first_name": "KIMBERLY",
"middle_name": "ERIN",
"credential": "CF-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-19",
"last_updated": "2020-06-19",
"certification_date": "2020-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "242.005893",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Aurora, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.