Provider Demographics
NPI:1750518205
Name:RHODES, LYNN (SLP/L)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:RHODES
Suffix:
Gender:F
Credentials:SLP/L
Other - Prefix:
Other - First Name:LYNN
Other - Middle Name:
Other - Last Name:RHODES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13157 W HALEY RD
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:IL
Mailing Address - Zip Code:60442-8508
Mailing Address - Country:US
Mailing Address - Phone:708-307-2463
Mailing Address - Fax:
Practice Address - Street 1:430 E 162ND ST
Practice Address - Street 2:SUITE 246
Practice Address - City:SOUTH HOLLAND
Practice Address - State:IL
Practice Address - Zip Code:60473-2258
Practice Address - Country:US
Practice Address - Phone:773-983-5273
Practice Address - Fax:708-474-5160
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-11
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242.001108235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist