Provider Demographics
NPI:1386090041
Name:REIMER, LINDSEY (MS,CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:
Last Name:REIMER
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:
Other - Last Name:BOHLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:3515 GOLF AVE
Mailing Address - Street 2:
Mailing Address - City:NEW LENOX
Mailing Address - State:IL
Mailing Address - Zip Code:60451-9628
Mailing Address - Country:US
Mailing Address - Phone:708-712-8938
Mailing Address - Fax:
Practice Address - Street 1:3515 GOLF AVE
Practice Address - Street 2:
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451
Practice Address - Country:US
Practice Address - Phone:708-712-8938
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-11
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.013683235Z00000X
390200000X
IL242.003943235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program