Active NPI
Kristina Nichole Bustamante, PHD, MA, BS, CCC-SLP
- Speech-Language Pathologist
- Geneva, IL
National Provider Identifier
1003206798
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 146.012209
- Practice address
- 302 Randall Rd
Geneva, IL 60134-4209 - Phone
- (630) 938-3637
- NPI assigned
- Feb 2, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 146.012209 | IL | Primary |
Addresses
Primary practice location
302 Randall Rd
Geneva, IL 60134-4209
Mailing address
2981 Savannah Dr
Aurora, IL 60502-8690
Phone (630) 506-0426
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
- Credentials
- Bachelor of Science, Master of Arts, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146.012209 | IL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1422835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754956800000",
"number": "1003206798",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2981 SAVANNAH DR",
"city": "AURORA",
"state": "IL",
"postal_code": "605028690",
"telephone_number": "630-506-0426"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "302 RANDALL RD",
"city": "GENEVA",
"state": "IL",
"postal_code": "601344209",
"telephone_number": "630-938-3637"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUSTAMANTE",
"first_name": "KRISTINA",
"middle_name": "NICHOLE",
"credential": "PHD, MA, BS, CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-02-02",
"last_updated": "2025-08-12",
"certification_date": "2025-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "146.012209",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Geneva, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.