Jessica Calderon, SLP
Individual provider Active NPI Speech-Language Pathologist · Lemont, IL
NPI 1104253830 · NPPES record last updated Feb 11, 2022
Key facts
- NPI
- 1104253830
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 146.012379 (IL)
- Practice address
- 11943 Pine Ave
Lemont, IL 60439-4507 - Phone
- (773) 676-5945
- NPI assigned
- Sep 26, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146.012379 | IL | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Autism and Childhood Therapy | Speech-Language Pathologist | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 146.012379 | IL | Yes |
Addresses
Primary practice location
11943 Pine Ave
Lemont, IL 60439-4507
Mailing address
11943 Pine Ave
Lemont, IL 60439-4507
Phone (773) 676-5945
Other providers in Lemont, IL
- Michael Anthony Buck
- Vicki J Burton
- Samantha Marie Bushnell
- Susan M Cahill
- Cristy M Calderon
- Dawn Marie Calhoun
- Caitlyn N Campbell
- Jacqueline Marie Carlock
- Nicole Carping
- Danilo Delegero Castigador
All providers in Lemont, IL · Speech-Language Pathologist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 11, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.