MEDICARE: LESLIE HINES SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	146011201	IL

General Provider Information

NPI Number	:	1225325707
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LESLIE HINES SLP

Provider Business Mailing Address
First Line	:	2548 W 116TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60655-1543
Country	:	US
Telephone Number	:	773-233-9133
Fax Number	:

Provider Business Practice Location Address
First Line	:	2548 W 116TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60655-1543
Country	:	US
Telephone Number	:	773-242-8915
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2011
Last Update Date	:	01/02/2025

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Directions to “ LESLIE HINES SLP” Practice Location

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