Woodstock Stuttering Specialist

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146.006432 Issued in IL

Legal business name

WOODSTOCK STUTTERING SPECIALIST

Practice address

110 Washington St
Woodstock, IL 60098-3305

Phone

(815) 308-5477

Fax

(815) 334-1136

NPI assigned

Apr 28, 2014

Last updated

Apr 28, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kevin Eldridge, PHDNPI 1568616944

Title

SLP/Sole Proprietor

Phone

(815) 403-1135

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kevin A Eldridge, PH.D., CCC-SLP

  • Speech-Language Pathologist
  • Woodstock, IL
  • NPI 1568616944
  NPD (past) Authorized official

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

{
    "created_epoch": "1398643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398643200000",
    "number": "1063822260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 WASHINGTON ST",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600983305",
            "telephone_number": "815-308-5477",
            "fax_number": "815-334-1136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 WASHINGTON ST",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600983305",
            "telephone_number": "815-308-5477",
            "fax_number": "815-334-1136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODSTOCK STUTTERING SPECIALIST",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-28",
        "last_updated": "2014-04-28",
        "status": "A",
        "authorized_official_last_name": "ELDRIDGE",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "SLP/SOLE PROPRIETOR",
        "authorized_official_telephone_number": "815-403-1135",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.006432",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1568616944",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Woodstock Fire/Rescue District
• Woodstock Imaging Associates, Inc.
• Woodstock Medical & Surgical Center, LTD
• Woodstock Nursing and Rehab Center LLC (La Bella of Woodstock)
• Woodstock School District
• Woodstock Therapist LLC
• Woodstock Urgent Care and Integrated Medicine PC
• Sandra E Woznicki, LCPC
• WRHC & RC Inc. (Woodstock Residence)
• Kristen M Young, AU.D.

• Speech-Language Pathologist in Woodstock, IL
• Providers in Woodstock, IL by specialty
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2014; 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.