Active NPI
Shamari Truss
- Speech-Language Pathologist
- Bridgeview, IL
National Provider Identifier
1104649615
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 242008092
- Practice address
- 8540 S Harlem Ave
Bridgeview, IL 60455-1778 - Phone
- (708) 598-2605
- NPI assigned
- Nov 4, 2024
- 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 | 242008092 | IL | Primary |
Addresses
Primary practice location
8540 S Harlem Ave
Bridgeview, IL 60455-1778
Mailing address
6233 S University Ave Apt 3
Chicago, IL 60637-2784
Other practice location 1
1010 W 95th St
Chicago, IL 60643-1580
Phone (773) 298-1177
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
| License | State | Type | Specialty |
|---|---|---|---|
| 242008092 | IL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1730678400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730678400000",
"number": "1104649615",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6233 S UNIVERSITY AVE APT 3",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606372784"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8540 S HARLEM AVE",
"city": "BRIDGEVIEW",
"state": "IL",
"postal_code": "604551778",
"telephone_number": "708-598-2605"
}
],
"practiceLocations": [
{
"address_1": "1010 W 95th St",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606431580",
"country_code": "US",
"telephone_number": "773-298-1177",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TRUSS",
"first_name": "SHAMARI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-11-04",
"last_updated": "2024-11-04",
"certification_date": "2024-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "242008092",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bridgeview, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.