Active NPI
Patricia Ellen Johnson, M.S. CCC-SP
- Speech-Language Pathologist
- Westmont, IL
National Provider Identifier
1093325342
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 146002453
- Practice address
- 750 Pasquinelli Dr Ste 204
Westmont, IL 60559-1291 - Phone
- (630) 560-0136
- NPI assigned
- Aug 2, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 | 146002453 | IL | Primary |
Addresses
Primary practice location
750 Pasquinelli Dr Ste 204
Westmont, IL 60559-1291
Mailing address
17W059 Terry TRL
Willowbrook, IL 60527-6021
Phone (630) 291-4988
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 |
|---|---|---|---|
| 146002453 | IL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1596326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596326400000",
"number": "1093325342",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17W059 TERRY TRL",
"city": "WILLOWBROOK",
"state": "IL",
"postal_code": "605276021",
"telephone_number": "630-291-4988"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "750 PASQUINELLI DR STE 204",
"city": "WESTMONT",
"state": "IL",
"postal_code": "605591291",
"telephone_number": "630-560-0136"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "PATRICIA",
"middle_name": "ELLEN",
"credential": "M.S. CCC-SP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-08-02",
"last_updated": "2020-08-02",
"certification_date": "2020-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "146002453",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Westmont, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.