Individual provider Active NPI

Lisa Marie Olson, M.H.S., CCC-SLP/L

  • Speech-Language Pathologist
  • Mokena, IL
National Provider Identifier
1043324460
Registry record updated Aug 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146007356 Issued in IL
Practice address
9026 Adare Ave
Mokena, IL 60448-9018
Phone
(708) 478-6588
Fax
(708) 478-8064
NPI assigned
Aug 19, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 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 146007356 IL Primary

Addresses

Primary practice location

9026 Adare Ave
Mokena, IL 60448-9018

Mailing address

9026 Adare Ave
Mokena, IL 60448-9018
Phone (708) 478-6588

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

State licenses

LicenseStateTypeSpecialty
146007356ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lets Talk Therapy Inc Speech-Language Pathologist Past Accepting new patients
Lets Talk Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346371200000",
    "number": "1043324460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9026 ADARE AVE",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604489018",
            "telephone_number": "708-478-6588",
            "fax_number": "708-478-8064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9026 ADARE AVE",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604489018",
            "telephone_number": "708-478-6588",
            "fax_number": "708-478-8064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "M.H.S., CCC-SLP/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2012-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146007356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mokena, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.