Individual provider Active NPI

Elizabeth Ann Hermanson, MS, CCC-SLP

  • Speech-Language Pathologist
  • New Lenox, IL
National Provider Identifier
1154443539
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
1135 Palmer Ranch Dr
New Lenox, IL 60451-3153
Phone
(708) 508-0856
Fax
(815) 463-9850
NPI assigned
Apr 4, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 IL Primary

Addresses

Primary practice location

1135 Palmer Ranch Dr
New Lenox, IL 60451-3153

Mailing address

1135 Palmer Ranch Dr
New Lenox, IL 60451-3153
Phone (708) 508-0856

Other identifiers 1

IdentifierTypeStateIssuer
EW17300799POtherILIL EARLY INTERVENTION

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
146006679ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154443539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 PALMER RANCH DR",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604513153",
            "telephone_number": "708-508-0856",
            "fax_number": "815-463-9850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 PALMER RANCH DR",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604513153",
            "telephone_number": "708-508-0856",
            "fax_number": "815-463-9850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERMANSON",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL EARLY INTERVENTION",
            "identifier": "EW17300799P",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Lenox, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.