Provider Demographics
NPI:1033576517
Name:HAMANN, ROBIN (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:HAMANN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:643 ENCLAVE LN
Mailing Address - Street 2:
Mailing Address - City:MANTENO
Mailing Address - State:IL
Mailing Address - Zip Code:60950-6000
Mailing Address - Country:US
Mailing Address - Phone:815-351-6044
Mailing Address - Fax:
Practice Address - Street 1:10071 W LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-1272
Practice Address - Country:US
Practice Address - Phone:815-464-6069
Practice Address - Fax:815-464-6970
Is Sole Proprietor?:No
Enumeration Date:2016-01-28
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146007176235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist