Kubelka, Lisa M

Kubelka, Lisa M is an individual health care provider with primary practice located at 209 9Th St Ste 302 , Rockford IL 61104-2235. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Kubelka, Lisa M can be contacted via phone (779) 696-4400.

Contact Information

Primary practice address
209 9Th St Ste 302 Rockford IL 61104-2235
Phone: (779) 696-4400
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 146.005286 Illinois

Profile Details

NPI number 1083995955
LBN Legal business name Kubelka, Lisa M
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 6th, 2011
Last updated Jan 9th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083995955 NPPES
Illinois Other 146.005286 SPEECH-LANGUAGE PATHOLOGIST

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