Individual provider Active NPI

Elizabeth Rose Wilkening, MHS

  • Speech-Language Pathologist
  • Lansing, IL
National Provider Identifier
1063132397
Registry record updated Aug 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146.017196 Issued in IL
Practice address
17845 Henry St
Lansing, IL 60438-2357
Phone
(708) 474-4320
NPI assigned
Aug 29, 2022
Last updated
Aug 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 46004190A IN
Speech-Language Pathologist 235Z00000X 146.017196 IL Primary

Addresses

Primary practice location

17845 Henry St
Lansing, IL 60438-2357

Mailing address

13980 Austin St
Cedar Lake, IN 46303-7608
Phone (219) 713-3196

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
146.017196ILMDSpeech-Language Pathologist
46004190AINMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1661731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692489600000",
    "number": "1063132397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13980 AUSTIN ST",
            "city": "CEDAR LAKE",
            "state": "IN",
            "postal_code": "463037608",
            "telephone_number": "219-713-3196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17845 HENRY ST",
            "city": "LANSING",
            "state": "IL",
            "postal_code": "604382357",
            "telephone_number": "708-474-4320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKENING",
        "first_name": "ELIZABETH",
        "middle_name": "ROSE",
        "credential": "MHS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-29",
        "last_updated": "2023-08-20",
        "certification_date": "2023-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "46004190A",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.017196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2023; 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.