Active NPI
Christine S Bieniecki Canada, MS CCC SLP
- Speech-Language Pathologist
- Granite City, IL
National Provider Identifier
1043736705
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 146007070
- Practice address
- 2300 West 25TH St
Granite City, IL 62040 - Phone
- (618) 451-5836
- NPI assigned
- Aug 15, 2017
- 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 | 146007070 | IL | Primary |
Addresses
Primary practice location
2300 West 25TH St
Granite City, IL 62040
Mailing address
2300 W 25TH St
Granite City, IL 62040-2025
Phone (618) 451-5836
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146007070 | IL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1043736705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2300 W 25TH ST",
"city": "GRANITE CITY",
"state": "IL",
"postal_code": "620402025",
"telephone_number": "618-451-5836"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2300 WEST 25TH ST",
"city": "GRANITE CITY",
"state": "IL",
"postal_code": "62040",
"telephone_number": "618-451-5836"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BIENIECKI CANADA",
"first_name": "CHRISTINE",
"middle_name": "S",
"credential": "MS CCC SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-15",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "146007070",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Granite City, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.