Individual provider Active NPI

Emily Joy Kettner

  • Speech-Language Pathologist
  • Chicago, IL
National Provider Identifier
1003129396
Registry record updated Jul 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
1332 W Wolfram St
Apartment 1
Chicago, IL 60657-4115
Phone
(616) 813-8851
NPI assigned
Jul 15, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X IL Primary

Addresses

Primary practice location

1332 W Wolfram St
Apartment 1
Chicago, IL 60657-4115

Mailing address

1332 W Wolfram St
Apartment 1
Chicago, IL 60657-4115
Phone (616) 813-8851

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1279152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279152000000",
    "number": "1003129396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1332 W WOLFRAM ST",
            "address_2": "APARTMENT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606574115",
            "telephone_number": "616-813-8851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1332 W WOLFRAM ST",
            "address_2": "APARTMENT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606574115",
            "telephone_number": "616-813-8851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETTNER",
        "first_name": "EMILY",
        "middle_name": "JOY",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-15",
        "last_updated": "2010-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.