Provider Demographics
NPI:1295524221
Name:BAHAN, HEIDI (MS CCC SLP)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:
Last Name:BAHAN
Suffix:
Gender:
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 COURTLAND ST N
Mailing Address - Street 2:
Mailing Address - City:SAYBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:61770-9783
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1120 N MELVIN ST
Practice Address - Street 2:
Practice Address - City:GIBSON CITY
Practice Address - State:IL
Practice Address - Zip Code:60936-1477
Practice Address - Country:US
Practice Address - Phone:217-784-4251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist