Individual provider Active NPI

Nicole Hillstrom

  • Speech-Language Pathologist
  • Wheaton, IL
National Provider Identifier
1114574175
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146.014991 Issued in IL
Practice address
140 E Loop Rd
Wheaton, IL 60189-8407
Phone
(312) 243-8487
NPI assigned
Aug 23, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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 146.014991 IL Primary

Addresses

Primary practice location

140 E Loop Rd
Wheaton, IL 60189-8407

Mailing address

304 N Loomis St
Chicago, IL 60607-1147
Phone (312) 243-8487

Other practice location 1

304 N Loomis St
Chicago, IL 60607-1147
Phone (312) 243-8487

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
146.014991ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Eyas Landing, Inc. Speech-Language Pathologist PastSince Aug 1, 2021 Accepting new patients
Blue Bird Day LLC Speech-Language Pathologist PastSince Aug 6, 2023 Accepting new patients
Bautz Developmental Intervention Inc Past Accepting new patients

Organizations & group practices 3

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": "1566518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1114574175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 N LOOMIS ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606071147",
            "telephone_number": "312-243-8487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 E LOOP RD",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601898407",
            "telephone_number": "312-243-8487"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "304 N Loomis St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606071147",
            "country_code": "US",
            "telephone_number": "312-243-8487",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HILLSTROM",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-23",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.014991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2023; 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.