Individual provider Active NPI

David Joseph Sheldon, LICENSED SPEECH-LANG

  • Speech-Language Pathologist
  • Park Forest, IL
National Provider Identifier
1093092793
Registry record updated Nov 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146.002168 Issued in IL
Practice address
51 Brook Park LN
Park Forest, IL 60466-2641
Phone
(708) 503-8243
NPI assigned
Nov 8, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 146.002168 IL Primary

Addresses

Primary practice location

51 Brook Park LN
Park Forest, IL 60466-2641

Mailing address

51 Brook Park LN
Park Forest, IL 60466-2641
Phone (708) 503-8243

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
146.002168ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1320710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320710400000",
    "number": "1093092793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 BROOK PARK LN",
            "city": "PARK FOREST",
            "state": "IL",
            "postal_code": "604662641",
            "telephone_number": "708-503-8243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 BROOK PARK LN",
            "city": "PARK FOREST",
            "state": "IL",
            "postal_code": "604662641",
            "telephone_number": "708-503-8243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELDON",
        "first_name": "DAVID",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "LICENSED SPEECH-LANG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-08",
        "last_updated": "2011-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.002168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Forest, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2011; 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.