Provider Demographics
NPI:1417285339
Name:HEPP, LANE COOPER (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LANE
Middle Name:COOPER
Last Name:HEPP
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:MISS
Other - First Name:LANE
Other - Middle Name:SMYTH
Other - Last Name:COOPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:15 COMMERCE DR
Mailing Address - Street 2:STE 116
Mailing Address - City:GRAYSLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030-7807
Mailing Address - Country:US
Mailing Address - Phone:847-223-7433
Mailing Address - Fax:847-223-7435
Practice Address - Street 1:15 COMMERCE DR
Practice Address - Street 2:STE 116
Practice Address - City:GRAYSLAKE
Practice Address - State:IL
Practice Address - Zip Code:60030-7807
Practice Address - Country:US
Practice Address - Phone:847-223-7433
Practice Address - Fax:847-223-7435
Is Sole Proprietor?:No
Enumeration Date:2009-12-04
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.010056235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist