Provider Demographics
NPI:1144607854
Name:BUEHNE, SADIE RAKERS (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:SADIE
Middle Name:RAKERS
Last Name:BUEHNE
Suffix:
Gender:F
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 1:11602 CHAD DR
Mailing Address - Street 2:
Mailing Address - City:AVISTON
Mailing Address - State:IL
Mailing Address - Zip Code:62216-1130
Mailing Address - Country:US
Mailing Address - Phone:618-570-8930
Mailing Address - Fax:
Practice Address - Street 1:11602 CHAD DR
Practice Address - Street 2:
Practice Address - City:AVISTON
Practice Address - State:IL
Practice Address - Zip Code:62216-1130
Practice Address - Country:US
Practice Address - Phone:618-570-8930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-01
Last Update Date:2015-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146011440235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist