Healthcare Provider Details

I. General information

NPI: 1740103266
Provider Name (Legal Business Name): SUNSHINE SPEECH THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3320 W FOSTER AVE PO BOX 204
CHICAGO IL
60625-4813
US

IV. Provider business mailing address

3320 W FOSTER AVE PO BOX 204
CHICAGO IL
60625-4813
US

V. Phone/Fax

Practice location:
  • Phone: 773-463-0865
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: ROSSY JIMENEZ
Title or Position: SPEECH-LANGUAGE PATHOLOGIST
Credential: CCC-SLP
Phone: 773-712-0386