Provider Demographics
NPI:1255491353
Name:SHEMBOR BISHOP, LILLI A (MA, CCC)
Entity Type:Individual
Prefix:
First Name:LILLI
Middle Name:A
Last Name:SHEMBOR BISHOP
Suffix:
Gender:F
Credentials:MA, CCC
Other - Prefix:
Other - First Name:LILLI
Other - Middle Name:A
Other - Last Name:SHEMBOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC
Mailing Address - Street 1:134 BUENA VISTA DR
Mailing Address - Street 2:
Mailing Address - City:DEKALB
Mailing Address - State:IL
Mailing Address - Zip Code:60115-1013
Mailing Address - Country:US
Mailing Address - Phone:815-753-6521
Mailing Address - Fax:
Practice Address - Street 1:1LUCINDA AVENUE
Practice Address - Street 2:NORTHERN ILLINOIS UNIV., SPEECH-LANGUAGE-HEARING CLINIC
Practice Address - City:DEKALB
Practice Address - State:IL
Practice Address - Zip Code:60115-2899
Practice Address - Country:US
Practice Address - Phone:815-753-6521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146002905235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist