Healthcare Provider Details

I. General information

NPI: 1841103017
Provider Name (Legal Business Name): CONFIDENT KIDS SPEECH THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 S DEVONSHIRE DR
BLOOMINGTON IL
61704-4677
US

IV. Provider business mailing address

105 S DEVONSHIRE DR
BLOOMINGTON IL
61704-4677
US

V. Phone/Fax

Practice location:
  • Phone: 847-340-0337
  • Fax:
Mailing address:
  • Phone: 847-340-0337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL

VIII. Authorized Official

Name: SARAH GREENBERG
Title or Position: SPEECH LANGUAGE PATHOLOGIST
Credential: MS CCC-SLP
Phone: 309-830-5203