Active NPI
Carolyn Anne Radecki, CF - SLP
- Speech-Language Pathologist
- Grayslake, IL
National Provider Identifier
1164013397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Practice address
- 649 Barron Blvd
Grayslake, IL 60030-1343 - Phone
- (847) 278-0458
- NPI assigned
- Jan 30, 2021
- Sex
- Female
- Sole proprietor
- Yes
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
649 Barron Blvd
Grayslake, IL 60030-1343
Mailing address
649 Barron Blvd
Grayslake, IL 60030-1343
Phone (847) 223-7433
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": "1611964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611964800000",
"number": "1164013397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "649 BARRON BLVD",
"city": "GRAYSLAKE",
"state": "IL",
"postal_code": "600301343",
"telephone_number": "847-223-7433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "649 BARRON BLVD",
"city": "GRAYSLAKE",
"state": "IL",
"postal_code": "600301343",
"telephone_number": "847-278-0458"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RADECKI",
"first_name": "CAROLYN",
"middle_name": "ANNE",
"credential": "CF - SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-01-30",
"last_updated": "2021-01-30",
"certification_date": "2021-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grayslake, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.