Healthcare Provider Details

I. General information

NPI: 1255260154
Provider Name (Legal Business Name): ERIN TIPPIT MS, CCC-SLP, CLC
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2026
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 N 1ST ST
SPRINGFIELD IL
62781-0001
US

IV. Provider business mailing address

828 S PARK AVE
SPRINGFIELD IL
62704-2334
US

V. Phone/Fax

Practice location:
  • Phone: 217-788-3000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number146016760
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: