Active NPI
Kassidy A Hansen
- Speech-Language Pathologist
- Morris, IL
National Provider Identifier
1043016041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Practice address
- 449 Edgewater Dr
Morris, IL 60450-8857 - Phone
- (815) 600-3076
- NPI assigned
- Feb 20, 2025
- Sex
- Female
- Sole proprietor
- Yes
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 | Primary |
Addresses
Primary practice location
449 Edgewater Dr
Morris, IL 60450-8857
Mailing address
25849 Lorenzo Rd
Wilmington, IL 60481-9329
Phone (815) 823-7395
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": "1740009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740009600000",
"number": "1043016041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25849 LORENZO RD",
"city": "WILMINGTON",
"state": "IL",
"postal_code": "604819329",
"telephone_number": "815-823-7395"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "449 EDGEWATER DR",
"city": "MORRIS",
"state": "IL",
"postal_code": "604508857",
"telephone_number": "815-600-3076"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANSEN",
"first_name": "KASSIDY",
"middle_name": "A",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-02-20",
"last_updated": "2025-02-20",
"certification_date": "2025-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Morris, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.