Individual provider Active NPI

Megan Shishman, CF-SLP

  • Speech-Language Pathologist
  • Oak Park, IL
National Provider Identifier
1164196226
Registry record updated Aug 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
242.006528 Issued in IL
Practice address
411 Chicago Ave
Oak Park, IL 60302-2233
Phone
(708) 524-1050
NPI assigned
Aug 3, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2021

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 242.006528 IL Primary

Addresses

Primary practice location

411 Chicago Ave
Oak Park, IL 60302-2233

Mailing address

1625 N Claremont Ave Apt 2R
Chicago, IL 60647-5267
Phone (574) 596-4800

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

LicenseStateTypeSpecialty
242.006528ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1627948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627948800000",
    "number": "1164196226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 N CLAREMONT AVE APT 2R",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606475267",
            "telephone_number": "574-596-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 CHICAGO AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603022233",
            "telephone_number": "708-524-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHISHMAN",
        "first_name": "MEGAN",
        "credential": "CF-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-03",
        "last_updated": "2021-08-03",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "242.006528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 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.

Verify at the official NPI Registry.