Active NPI
Marla Joy Serdar, SLP
- Speech-Language Pathologist
- Zion, IL
National Provider Identifier
1043557515
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 146002710
- Practice address
- 43465 N Lynndale Dr
Zion, IL 60099-9588 - Phone
- (847) 366-1107
- NPI assigned
- Jan 3, 2013
- 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 | 146002710 | IL | Primary |
Addresses
Primary practice location
43465 N Lynndale Dr
Zion, IL 60099-9588
Mailing address
43465 N Lynndale Dr
Zion, IL 60099-9588
Phone (847) 366-1107
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
| License | State | Type | Specialty |
|---|---|---|---|
| 146002710 | IL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1357171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371772800000",
"number": "1043557515",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "43465 N LYNNDALE DR",
"city": "ZION",
"state": "IL",
"postal_code": "600999588",
"telephone_number": "847-366-1107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "43465 N LYNNDALE DR",
"city": "ZION",
"state": "IL",
"postal_code": "600999588",
"telephone_number": "847-366-1107"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SERDAR",
"first_name": "MARLA",
"middle_name": "JOY",
"name_prefix": "Mrs.",
"credential": "SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-01-03",
"last_updated": "2013-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "146002710",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Zion, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.