Brooke Marie Nguyen, M.S. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

242.005723 Issued in IL

Practice address

2103 N Veterans Pkwy
Bloomington, IL 61704-0908

Phone

(309) 948-6469

NPI assigned

Aug 28, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1598572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651104000000",
    "number": "1134732001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 416501",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022417594",
            "telephone_number": "309-948-6469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2103 N VETERANS PKWY",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617040908",
            "telephone_number": "309-948-6469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "BROOKE",
        "middle_name": "MARIE",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-28",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "242.005723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "242.005723",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Diane Neuweg, MA, NCC
• Joseph Kaysing Newcomer, M.D.
• Carlie Ann Newton
• Darci Newton
• Jessica Jo Newton, OTR/L
• Vy Charles Nhem, PHARMD
• Selena Ni
• Azfar Khan Niazi, MD
• Jenifer Joan Nibbio, LCSW
• Thomas P. Niebur, LCPC, LMFT, CSAT

• Speech-Language Pathologist in Bloomington, IL
• Providers in Bloomington, 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 28, 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.