Provider Demographics
NPI:1417474081
Name:ZIMMER, JAMIE (MS, CCC-SLP/L)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:ZIMMER
Suffix:
Gender:F
Credentials:MS, CCC-SLP/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9804 COOK AVE
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-3071
Mailing Address - Country:US
Mailing Address - Phone:708-712-1408
Mailing Address - Fax:
Practice Address - Street 1:9804 COOK AVE
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-3071
Practice Address - Country:US
Practice Address - Phone:708-712-1408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-24
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242.004441235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist