Organization Active NPI

Fenton Speech and Voice PLLC

  • Speech-Language Pathologist
  • Wheaton, IL
National Provider Identifier
1063278612
Registry record updated Jul 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
FENTON SPEECH AND VOICE PLLC
Practice address
1016 Michigan St
Wheaton, IL 60187-5706
Phone
(630) 254-3171
NPI assigned
Feb 22, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2024

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

Authorized official

Name
Erica FentonNPI 1184295537
Title
Owner
Phone
(630) 344-9056

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

1016 Michigan St
Wheaton, IL 60187-5706

Mailing address

1016 Michigan St
Wheaton, IL 60187-5706

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240726002979 IL Part B Supplier - Clinic/Group Practice 2769928613 Receives reassigned benefits from 1 practitioner
Practice locations: Wheaton, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1708560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722038400000",
    "number": "1063278612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1016 MICHIGAN ST",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601875706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1016 MICHIGAN ST",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601875706",
            "telephone_number": "630-254-3171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FENTON SPEECH AND VOICE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-22",
        "last_updated": "2024-07-27",
        "certification_date": "2024-07-27",
        "status": "A",
        "authorized_official_last_name": "FENTON",
        "authorized_official_first_name": "ERICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-344-9056"
    },
    "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 Wheaton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.