Individual provider Active NPI

Susan Pruitt Gruhlke

  • Speech-Language Pathologist
  • Arlington Heights, IL
National Provider Identifier
1104326701
Registry record updated Feb 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146.002658 Issued in IL
Practice address
2016 E Saint James St
Arlington Heights, IL 60004-6461
Phone
(224) 409-7150
Fax
(224) 324-8455
NPI assigned
Feb 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2018

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 146.002658 IL Primary

Addresses

Primary practice location

2016 E Saint James St
Arlington Heights, IL 60004-6461

Mailing address

1204 W Heather LN
Arlington Heights, IL 60005-1155
Phone (847) 902-6558

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
146.002658ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Beth Deiter, LTD. Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1519084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519084800000",
    "number": "1104326701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 W HEATHER LN",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600051155",
            "telephone_number": "847-902-6558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2016 E SAINT JAMES ST",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600046461",
            "telephone_number": "224-409-7150",
            "fax_number": "224-324-8455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUHLKE",
        "first_name": "SUSAN",
        "middle_name": "PRUITT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-20",
        "last_updated": "2018-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.002658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2018; 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.