Healthcare Provider Details

I. General information

NPI: 1316227531
Provider Name (Legal Business Name): AARON DOUBET
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2011
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 S UNIVERSITY CAMPUS BOX 4720
NORMAL IL
61790-4720
US

IV. Provider business mailing address

275 S UNIVERSITY ST CAMPUS BOX
NORMAL IL
61790-4720
US

V. Phone/Fax

Practice location:
  • Phone: 309-438-8641
  • Fax: 800-611-3697
Mailing address:
  • Phone: 309-438-8641
  • Fax: 800-611-3697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number146017400
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: