Active NPI
Jillian Alissa Kolquist
- Speech-Language Pathologist
- Chandler, AZ
National Provider Identifier
1174976997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SLP10104
- Practice address
- 2300 S Gardner Dr
Chandler, AZ 85286-8349 - Phone
- (480) 883-4300
- NPI assigned
- Jul 16, 2016
- Sex
- Female
- Sole proprietor
- No
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 | SLP10104 | AZ | Primary |
Addresses
Primary practice location
2300 S Gardner Dr
Chandler, AZ 85286-8349
Mailing address
17100 E Shea Blvd Ste 225
Fountain Hills, AZ 85268-6744
Phone (218) 393-0907
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 |
|---|---|---|---|
| TSLP10104 | AZ | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468627200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787702400000",
"number": "1174976997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17100 E SHEA BLVD STE 225",
"city": "FOUNTAIN HILLS",
"state": "AZ",
"postal_code": "852686744",
"telephone_number": "218-393-0907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2300 S GARDNER DR",
"city": "CHANDLER",
"state": "AZ",
"postal_code": "852868349",
"telephone_number": "480-883-4300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOLQUIST",
"first_name": "JILLIAN",
"middle_name": "ALISSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-16",
"last_updated": "2026-08-26",
"certification_date": "2026-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AZ",
"license": "SLP10104",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chandler, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.