Active NPI
Camille Ponce Kasprzak
- Speech-Language Pathologist
- Park Ridge, IL
National Provider Identifier
1033514641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 242003037
- Practice address
- 1675 Dempster St
Park Ridge, IL 60068-1110 - Phone
- (847) 723-4532
- Fax
- (847) 723-4540
- NPI assigned
- Oct 24, 2014
- 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 | 242003037 | IL | Primary |
Addresses
Primary practice location
1675 Dempster St
Park Ridge, IL 60068-1110
Mailing address
160 Orchard Pass
Bartlett, IL 60103
Phone (847) 409-0366
Other practice location 1
1001 Oak Ridge Dr
Streamwood, IL 60107-2185
Phone (847) 409-0366
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ckasprzak219110@direct.myadvocateaurora.org | ||
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 242003037 | IL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1414108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653436800000",
"number": "1033514641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "160 ORCHARD PASS",
"city": "BARTLETT",
"state": "IL",
"postal_code": "60103",
"telephone_number": "847-409-0366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1675 DEMPSTER ST",
"city": "PARK RIDGE",
"state": "IL",
"postal_code": "600681110",
"telephone_number": "847-723-4532",
"fax_number": "847-723-4540"
}
],
"practiceLocations": [
{
"address_1": "1001 Oak Ridge Dr",
"address_purpose": "LOCATION",
"city": "Streamwood",
"state": "IL",
"postal_code": "601072185",
"country_code": "US",
"telephone_number": "847-409-0366",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KASPRZAK",
"first_name": "CAMILLE",
"middle_name": "PONCE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-10-24",
"last_updated": "2022-05-25",
"certification_date": "2022-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "242003037",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ckasprzak219110@direct.myadvocateaurora.org",
"affiliation": "N",
"address_1": "1675 Dempster St",
"city": "Park Ridge",
"state": "IL",
"country_code": "US",
"postal_code": "600681110",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "1675 Dempster St",
"city": "Park Ridge",
"state": "IL",
"country_code": "US",
"postal_code": "600681110",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Park Ridge, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.