Mackenzi Jo Tallcott, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146013992 Issued in IL

Practice address

2631 Ken Ray Dr
Quincy, IL 62301-6117

Phone

(217) 209-1748

NPI assigned

Sep 14, 2016

Sex

Female

Sole proprietor

Yes

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)

Enrolled

Credentials

Master of Science

Practice roles

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.

• Achieve Speech Therapy, PLLC

  • Speech-Language Pathologist
  • Quincy, IL
  • NPI 1043027105
  NPD Authorized official

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

{
    "created_epoch": "1473811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650240000000",
    "number": "1104374602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2631 KEN RAY DR",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623016117",
            "telephone_number": "217-209-1748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2631 KEN RAY DR",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623016117",
            "telephone_number": "217-209-1748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALLCOTT",
        "first_name": "MACKENZI",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-14",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146013992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hollis Stephen Swink, MA, ICCS, LCPC, CAAD
• Sycamore Healthcare Centre
• Sycamore Operator LLC
• Koretta G Sykes
• Malik Sylvester, BS MHP
• Roula Y. Tanios, M.D.
• Diane Tappe
• Kori C Tappe, CLD CPD CLSE LMT
• Marybeth Tatum, RPH
• Ruth Charity Taylor, CRNA

• Speech-Language Pathologist in Quincy, IL
• Providers in Quincy, 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 Apr 18, 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.