BLAKE SELF (NPI# 1164887592) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164887592 |
| Entity Type | Individual |
| Full Name | BLAKE SELF |
| Credential | CCC-SLP |
| Practice Address |
5704 Wonder Woods Drive Wonder Lake IL 60097 |
| Practice Telephone | 8476367603 |
| Mailing Telephone | 8476367603 |
| Enumeration Date | 2015-12-30 |
| Last Update Date | 2015-12-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 235Z00000X | Speech-Language Pathologist | 146012447 | IL | Speech, Language and Hearing Service Providers |
| Street Address |
5704 WONDER WOODS DRIVE |
| City | WONDER LAKE |
| State | IL |
| Zip Code | 60097 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649629346 | Catina Ballin | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 8808 Riley Road, Wonderlake, IL 60097 | 2016-06-03 |
| 1518301944 | Jill Horan | Social Worker | 8202 Howe Rd, Wonder Lake, IL 60097 | 2013-04-29 |
| 1720259013 | Gregory V. Sierminski, D.d.s., P.C. | Dentist | 7442 Hancock Drive, Crystal Lake, IL 60097 | 2008-03-14 |
| 1255386801 | Gregory V Sierminski | Dentist | 7442 Hancock Dr, Wonder Lake, IL 60097 | 2006-05-23 |
| 1952469215 | Arun Narang | Internal Medicine | 7432 Hancock Dr, Wonder Lake, IL 60097 | 2006-12-05 |
| 1467574780 | Wonder Lake Fire Protection District | Ambulance | 4300 E Wonder Lake Road, Wonder Lake, IL 60097-0447 | 2007-04-06 |
| 1003852476 | Lois Jean Wenkel | Speech-Language Pathologist | 5622 Woodlane Dr, Wonder Lake, IL 60097-8123 | 2006-06-22 |
| 1962998492 | Michele Young | Nurse Practitioner | 9295 Rachel Dr, Wonder Lake, IL 60097-8181 | 2018-07-09 |
| 1750538443 | Elizabeth M Scherer | Speech-Language Pathologist | 3716 Ridge Ln, Wonder Lake, IL 60097-8265 | 2008-08-25 |
| 1881184919 | Billie Noell Swanson | Behavior Technician | 4108 E Lake Shore Dr, Wonder Lake, IL 60097-8398 | 2018-05-14 |
| Find all providers in zip 60097 | ||||
| Taxonomy Code | 235Z00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Speech-Language Pathologist |
| The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. |
| Notes: "Scope of Practice in Speech-Language Pathology", American Speech-Language-Hearing Association, 2013. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750538443 | Elizabeth M Scherer | Speech-Language Pathologist | 3716 Ridge Ln, Wonder Lake, IL 60097-8265 | 2008-08-25 |
| 1235273756 | Driscoll Pediatric Speech Services, Inc. | Speech-Language Pathologist | 7709 Catalpa Dr, Wonder Lake, IL 60097-9259 | 2007-02-16 |
| 1003852476 | Lois Jean Wenkel | Speech-Language Pathologist | 5622 Woodlane Dr, Wonder Lake, IL 60097-8123 | 2006-06-22 |
| 1043868953 | Kristi Newman | Speech-Language Pathologist | 6809 Mccullom Lake Rd, Wonder Lake, IL 60097-9546 | 2019-09-04 |
| 1487211298 | Kara Lampinen | Speech-Language Pathologist | 6809 Mccullom Lake Rd, Wonder Lake, IL 60097-9546 | 2019-05-28 |
| 1801015508 | Amanda Driscoll | Speech-Language Pathologist | 7709 Catalpa Dr, Wonder Lake, IL 60097-9259 | 2007-04-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780285429 | Lily Heine | Speech-Language Pathologist | 1425 W Albion Ave Apt 3, Chicago, IL 60626-5022 | 2020-11-07 |
| 1194326363 | Cheryl Clemens | Speech-Language Pathologist | 105 Clubhouse Pl, Mount Carmel, IL 62863-2711 | 2020-11-04 |
| 1164022588 | Mary Kate Zagotta | Speech-Language Pathologist | 555 W Kinzie St Apt 1608, Chicago, IL 60654-5847 | 2020-10-26 |
| 1942809231 | Progress To Success Speech Therapy Pllc | Speech-Language Pathologist | 4940 Wilderness Pt, Smithton, IL 62285-3664 | 2020-10-19 |
| 1134727134 | Madison Frazier | Speech-Language Pathologist | 1221 N Dearborn St Apt 1206n, Chicago, IL 60610-8377 | 2020-10-12 |
| 1295332617 | Rachel Raffalo | Speech-Language Pathologist | 1050 S Euclid Ave, Elmhurst, IL 60126-5169 | 2020-10-08 |
| 1336746809 | Karen M Olson | Speech-Language Pathologist | 4506 N Ashland Ave Apt 1s, Chicago, IL 60640-5445 | 2020-10-07 |
| 1255938908 | Norma Laura Gregorio-perez | Speech-Language Pathologist | 1601 E Main St # G, St Charles, IL 60174-2431 | 2020-10-06 |
| 1073110227 | Erin Koester | Speech-Language Pathologist | 633 County Highway 22, Cowden, IL 62422-4104 | 2020-10-01 |
| 1609483072 | Claire Elaine Rayburn | Speech-Language Pathologist | 2142 W Walton St Apt 2, Chicago, IL 60622-4893 | 2020-09-29 |
| Find all providers with the same taxonomy | ||||
| City | WONDER LAKE |
| Zip Code | 60097 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.