Provider Demographics
NPI:1972623668
Name:JOPLIN, CYNDI LUANN (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:CYNDI
Middle Name:LUANN
Last Name:JOPLIN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 WOODBINE DR
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-5050
Mailing Address - Country:US
Mailing Address - Phone:815-788-1020
Mailing Address - Fax:815-788-1422
Practice Address - Street 1:4701 N OAK ST
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60012-3309
Practice Address - Country:US
Practice Address - Phone:815-788-1020
Practice Address - Fax:815-788-1422
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0035640653OtherBLUE CROSS BLUE SHIELD
IL303546180001Medicaid