Active NPI
Paige Jenkins
- Speech-Language Pathologist
- Lemont, IL
National Provider Identifier
1164904199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 242004883
- Practice address
- 1130 Kim PL
Lemont, IL 60439-4317 - Phone
- (630) 257-2286
- NPI assigned
- Sep 6, 2018
- 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 | 242004883 | IL | Primary |
Addresses
Primary practice location
1130 Kim PL
Lemont, IL 60439-4317
Mailing address
1130 Kim PL
Lemont, IL 60439-4317
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 242004883 | Medicaid | IL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 242004883 | IL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628208000000",
"number": "1164904199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1130 KIM PL",
"city": "LEMONT",
"state": "IL",
"postal_code": "604394317"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1130 KIM PL",
"city": "LEMONT",
"state": "IL",
"postal_code": "604394317",
"telephone_number": "630-257-2286"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENKINS",
"first_name": "PAIGE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-09-06",
"last_updated": "2021-08-06",
"certification_date": "2021-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "242004883",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "242004883",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lemont, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.