Doctor Name: | DR. JOHN T. LYBOLT |
NPI Number: | 1659545408 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CCC-SLP |
License Number: | 146003355 |
Business Practice Address: | 900 Skokie Blvd Suite Number 215 Northbrook, IL - 600624012 |
Business Phone Number: | 8475649230 |
Business Fax Number: | 8475649258 |
Mailing Address: | 900 Skokie Blvd, Suite Number 215 NORTHBROOK |
State: | IL |
Postal Code: | 600624012 |
Phone Number: | 8475649230 |
Fax Number: | 8475649258 |
NPI Enumeration Date: | 04/14/2008 |
NPI Last Update Date: | 02/18/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 146003355 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |