Healthcare Provider Details

I. General information

NPI: 1417235573
Provider Name (Legal Business Name): SHINE THERAPY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2011
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14615 W FOX CREEK CT
BRIMFIELD IL
61517-9529
US

IV. Provider business mailing address

14615 W FOX CREEK CT
BRIMFIELD IL
61517-9529
US

V. Phone/Fax

Practice location:
  • Phone: 309-258-0084
  • Fax: 866-319-1546
Mailing address:
  • Phone: 309-258-0084
  • Fax: 866-319-1546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name: MS. SARAH KATHLEEN ZIEMBA
Title or Position: OWNER/SPEECH-LANGUAGE PATHOLOGIST
Credential: M.A.CCC-SLP
Phone: 309-258-0084