Provider Demographics
NPI:1023260965
Name:LOVEL, KEVIN A (MS, CCC-SLP/L)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:A
Last Name:LOVEL
Suffix:
Gender:M
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 1:901 CEMETERY RD
Mailing Address - Street 2:
Mailing Address - City:JERSEYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62052-1212
Mailing Address - Country:US
Mailing Address - Phone:618-498-4828
Mailing Address - Fax:
Practice Address - Street 1:410 FLETCHER ST
Practice Address - Street 2:
Practice Address - City:JERSEYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62052-2127
Practice Address - Country:US
Practice Address - Phone:618-498-6427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-22
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.009325235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist