Healthcare Provider Details

I. General information

NPI: 1043157498
Provider Name (Legal Business Name): SOPHIA LOUISE BACHMAN
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 S ADDISON AVE
VILLA PARK IL
60181-2877
US

IV. Provider business mailing address

830 S ADDISON AVE
VILLA PARK IL
60181-2877
US

V. Phone/Fax

Practice location:
  • Phone: 630-620-4433
  • 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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: