Individual provider Active NPI

Genevieve Marie D'Aquila

  • Speech-Language Pathologist
  • Chicago, IL
National Provider Identifier
1003188863
Registry record updated Feb 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146009555 Issued in IL
Practice address
1366 W Fullerton Ave
Chicago, IL 60614-2129
Phone
(772) 248-9300
NPI assigned
Feb 8, 2012
Last updated
Feb 8, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2012

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 146009555 IL Primary

Addresses

Primary practice location

1366 W Fullerton Ave
Chicago, IL 60614-2129

Mailing address

909 W Washington Blvd
No. 712
Chicago, IL 60607-2204
Phone (312) 421-1654

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
146009555ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1328659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328659200000",
    "number": "1003188863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 W WASHINGTON BLVD",
            "address_2": "NO. 712",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606072204",
            "telephone_number": "312-421-1654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1366 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606142129",
            "telephone_number": "772-248-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'AQUILA",
        "first_name": "GENEVIEVE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-08",
        "last_updated": "2012-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146009555",
            "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 Feb 8, 2012; 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.