Teresa Jeannette Doherty

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146.015417 Issued in IL

Practice address

2990 N Perryville Rd Unit 1100
Rockford, IL 61107-6827

Phone

(815) 469-1500

NPI assigned

May 13, 2019

Last updated

Nov 30, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Beyond Play LLC

  • Early Intervention Provider Agency
  • Crystal Lake, IL
  • NPI 1053967273

  Speech-Language Pathologist

  NPD (past)
• Westside Childrens Therapy

  • Physical Therapist
  • Joliet, IL
  • NPI 1972783900

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1557705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1093371221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2990 N PERRYVILLE RD UNIT 1100",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611076827",
            "telephone_number": "815-469-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2990 N PERRYVILLE RD UNIT 1100",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611076827",
            "telephone_number": "815-469-1500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1928 James Ct",
            "address_purpose": "LOCATION",
            "city": "Schaumburg",
            "state": "IL",
            "postal_code": "601943845",
            "country_code": "US",
            "telephone_number": "847-278-1851",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "420 Sunrise Ln",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611074948",
            "country_code": "US",
            "telephone_number": "815-975-4030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOHERTY",
        "first_name": "TERESA",
        "middle_name": "JEANNETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-13",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.015417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason M Doetch, PA-C
• Kamey Doetch
• Chang Ha Doh, DPT
• Adrienne Doherty, LCPC
• Andrew T Doherty, PA-C
• Dennis Navarro Dolleton, MD
• Crystal Dollinger
• Meredith Domanico, LPC
• Charlene J Donahoe, MS, LPC
• Lindsay Donaldson, L.P.C.

• Speech-Language Pathologist in Rockford, IL
• Providers in Rockford, 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 Nov 30, 2022; 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.