Provider Demographics
NPI:1881184539
Name:LORI L. SONNENBERG, LTD.
Entity Type:Organization
Organization Name:LORI L. SONNENBERG, LTD.
Other - Org Name:LORI L. SONNENBERG, MM, MA, CCC-SLP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, LICENSED SPEECH PATHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SONNENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:630-442-1883
Mailing Address - Street 1:1431 OPUS PL STE 110
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-1164
Mailing Address - Country:US
Mailing Address - Phone:630-442-1883
Mailing Address - Fax:
Practice Address - Street 1:1431 OPUS PL STE 110
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-1164
Practice Address - Country:US
Practice Address - Phone:630-442-1883
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LORI L. SONNENBERG, LTD.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-05-17
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.008668235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty