Organization Active NPI

Peach Coast Therapy LLC

  • Speech-Language Pathologist
  • Chicago, IL
National Provider Identifier
1013726009
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
PEACH COAST THERAPY LLC
Practice address
5616 N Kenmore Ave Apt 3a
Chicago, IL 60660-4609
Phone
(412) 512-9469
NPI assigned
Jan 3, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

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

Authorized official

Name
Elizabeth Stenger, M.S. CCC-SLPNPI 1609585942
Title
Registered Agent
Phone
(412) 512-9469

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

5616 N Kenmore Ave Apt 3a
Chicago, IL 60660-4609

Mailing address

5616 N Kenmore Ave Apt 3a
Chicago, IL 60660-4609
Phone (412) 512-9469

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1735862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735862400000",
    "number": "1013726009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5616 N KENMORE AVE APT 3A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606604609",
            "telephone_number": "412-512-9469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5616 N KENMORE AVE APT 3A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606604609",
            "telephone_number": "412-512-9469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACH COAST THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-03",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A",
        "authorized_official_last_name": "STENGER",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "REGISTERED AGENT",
        "authorized_official_telephone_number": "412-512-9469",
        "authorized_official_credential": "M.S. CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "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 Jan 3, 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.

Verify at the official NPI Registry.