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NPI Code Detail

MEDICARE: MS. CYNDI LUANN JOPLIN MA, CCC-SLP

MEDICARE: MS. CYNDI LUANN JOPLIN MA, CCC-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
1235Z00000XSpeech-Language PathologistIL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10035640653OTHERILBLUE CROSS BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1972623668
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CYNDI LUANN JOPLIN MA, CCC-SLP
Provider Business Mailing Address
First Line : 82 WOODBINE DR
Second Line :
City : CRYSTAL LAKE
State : IL
Zip : 60014-5050
Country : US
Telephone Number : 815-788-1020
Fax Number : 815-788-1422
Provider Business Practice Location Address
First Line : 4701 N OAK ST
Second Line :
City : CRYSTAL LAKE
State : IL
Zip : 60012-3309
Country : US
Telephone Number : 815-788-1020
Fax Number : 815-788-1422
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2007
Last Update Date : 07/08/2007

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Directions to “ MS. CYNDI LUANN JOPLIN MA, CCC-SLP” Practice Location

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