Individual provider Active NPI

Dorothea Ellen Gilliland, SLP

  • Speech-Language Pathologist
  • Woodstock, IL
National Provider Identifier
1164723375
Registry record updated Nov 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146004203 Issued in IL
Practice address
708 Washington St
Woodstock, IL 60098-2265
Phone
(815) 338-1707
Fax
(815) 338-1786
NPI assigned
Nov 4, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2010

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 146004203 IL Primary

Addresses

Primary practice location

708 Washington St
Woodstock, IL 60098-2265

Mailing address

708 Washington St
Woodstock, IL 60098-2265
Phone (815) 338-1707

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
146004203ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1288828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288828800000",
    "number": "1164723375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 WASHINGTON ST",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600982265",
            "telephone_number": "815-338-1707",
            "fax_number": "815-338-1786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 WASHINGTON ST",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600982265",
            "telephone_number": "815-338-1707",
            "fax_number": "815-338-1786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLILAND",
        "first_name": "DOROTHEA",
        "middle_name": "ELLEN",
        "name_prefix": "Ms.",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-04",
        "last_updated": "2010-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146004203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2010; 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.