Active NPI
Iyuna Harris, MOT
- Speech-Language Pathologist
- Flossmoor, IL
National Provider Identifier
1144576430
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 146010459
- Practice address
- 19740 Governors Hwy
Ste 118
Flossmoor, IL 60422-2084 - Phone
- (708) 799-5569
- NPI assigned
- Jul 24, 2012
- 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 | 146010459 | IL | Primary |
Addresses
Primary practice location
19740 Governors Hwy
Ste 118
Flossmoor, IL 60422-2084
Mailing address
443 Victory Dr
Park Forest, IL 60466-2084
Phone (773) 844-9235
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 |
|---|---|---|---|
| 146010459 | IL | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southland College Prep Charter School Inc | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Local Education Agency (LEA)
- Richton Park, IL
- NPI 1962125237
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343088000000",
"number": "1144576430",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "443 VICTORY DR",
"city": "PARK FOREST",
"state": "IL",
"postal_code": "604662084",
"telephone_number": "773-844-9235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19740 GOVERNORS HWY",
"address_2": "STE 118",
"city": "FLOSSMOOR",
"state": "IL",
"postal_code": "604222084",
"telephone_number": "708-799-5569"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "IYUNA",
"credential": "MOT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-24",
"last_updated": "2012-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "146010459",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flossmoor, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.