Active NPI
Mary Venegoni, SLP
- Speech-Language Pathologist
- Washington, IL
National Provider Identifier
1104193549
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Practice address
- 209 N Cummings LN
Washington, IL 61571-2181 - Phone
- (309) 866-2305
- Fax
- (309) 444-3893
- NPI assigned
- Nov 30, 2011
- Sex
- Female
- Sole proprietor
- No
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 | Primary |
Addresses
Primary practice location
209 N Cummings LN
Washington, IL 61571-2181
Mailing address
209 N Cummings LN
Washington, IL 61571-2181
Phone (309) 866-2305
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1322611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322611200000",
"number": "1104193549",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "209 N CUMMINGS LN",
"city": "WASHINGTON",
"state": "IL",
"postal_code": "615712181",
"telephone_number": "309-866-2305",
"fax_number": "309-444-3893"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "209 N CUMMINGS LN",
"city": "WASHINGTON",
"state": "IL",
"postal_code": "615712181",
"telephone_number": "309-866-2305",
"fax_number": "309-444-3893"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VENEGONI",
"first_name": "MARY",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-11-30",
"last_updated": "2011-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.