Active NPI
Jessica Lynn Potter
- Speech-Language Pathologist
- Lansing, IL
National Provider Identifier
1124802087
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Practice address
- 17845 Henry St
Lansing, IL 60438-2357 - Phone
- (708) 474-4320
- NPI assigned
- Aug 22, 2023
- 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 | IL | Primary |
Addresses
Primary practice location
17845 Henry St
Lansing, IL 60438-2357
Mailing address
10627 S Spaulding Ave
Chicago, IL 60655-2519
Phone (773) 766-7693
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692662400000",
"number": "1124802087",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10627 S SPAULDING AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606552519",
"telephone_number": "773-766-7693"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17845 HENRY ST",
"city": "LANSING",
"state": "IL",
"postal_code": "604382357",
"telephone_number": "708-474-4320"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POTTER",
"first_name": "JESSICA",
"middle_name": "LYNN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-22",
"last_updated": "2023-08-22",
"certification_date": "2023-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lansing, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.