Provider Demographics
NPI:1700143310
Name:STEARS, KAILYNNE DORINDA JEAN (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KAILYNNE
Middle Name:DORINDA JEAN
Last Name:STEARS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:MISS
Other - First Name:KAILYNNE
Other - Middle Name:DORINDA JEAN
Other - Last Name:HILLENBURG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 DORNBUSH DR
Mailing Address - Street 2:
Mailing Address - City:MINONK
Mailing Address - State:IL
Mailing Address - Zip Code:61760-1363
Mailing Address - Country:US
Mailing Address - Phone:309-261-9008
Mailing Address - Fax:
Practice Address - Street 1:618 W 4TH ST
Practice Address - Street 2:
Practice Address - City:MINONK
Practice Address - State:IL
Practice Address - Zip Code:61760-1424
Practice Address - Country:US
Practice Address - Phone:309-261-9008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-19
Last Update Date:2017-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242.001929235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist