Provider Demographics
NPI:1386321560
Name:BAKKE, TAYLOR (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:BAKKE
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 1:24402 W LOCKPORT ST STE 124
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-4288
Mailing Address - Country:US
Mailing Address - Phone:815-239-0395
Mailing Address - Fax:815-239-0408
Practice Address - Street 1:24402 W LOCKPORT ST STE 124
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-4288
Practice Address - Country:US
Practice Address - Phone:815-239-0395
Practice Address - Fax:815-239-0408
Is Sole Proprietor?:No
Enumeration Date:2023-06-29
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist