Individual provider Active NPI

Molly Marie Gruszeczka Webb, CCC-SLP/L

  • Speech-Language Pathologist
  • Crystal Lake, IL
National Provider Identifier
1164806576
Registry record updated Nov 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146.012539 Issued in IL
Practice address
1719 Hartford LN
Crystal Lake, IL 60014-2017
Phone
(847) 840-6768
NPI assigned
Jul 15, 2015
Last updated
Nov 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2022

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 146.012539 IL Primary

Addresses

Primary practice location

1719 Hartford LN
Crystal Lake, IL 60014-2017

Mailing address

1719 Hartford LN
Crystal Lake, IL 60014-2017
Phone (847) 840-6768

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
146.012539ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Speech and Language Professionals, Inc Speech-Language Pathologist Past 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1436918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1164806576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1719 HARTFORD LN",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600142017",
            "telephone_number": "847-840-6768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1719 HARTFORD LN",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600142017",
            "telephone_number": "847-840-6768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBB",
        "first_name": "MOLLY",
        "middle_name": "MARIE GRUSZECZKA",
        "credential": "CCC-SLP/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-15",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.012539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; 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.