Provider Demographics
NPI:1275179947
Name:HUBNER, GINGER ANN
Entity Type:Individual
Prefix:MRS
First Name:GINGER
Middle Name:ANN
Last Name:HUBNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5201 E 1850 NORTH RD
Mailing Address - Street 2:
Mailing Address - City:FITHIAN
Mailing Address - State:IL
Mailing Address - Zip Code:61844-5212
Mailing Address - Country:US
Mailing Address - Phone:815-821-3804
Mailing Address - Fax:
Practice Address - Street 1:400 E WABASH AVE
Practice Address - Street 2:
Practice Address - City:RANTOUL
Practice Address - State:IL
Practice Address - Zip Code:61866-3013
Practice Address - Country:US
Practice Address - Phone:217-893-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-18
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.008129235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist