Active NPI
Elizabeth Patrick
- Speech-Language Pathologist
- Highland, IL
National Provider Identifier
1194244301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 146012208
- Practice address
- 1600 Lindenthal Ave
Highland, IL 62249-2203 - Phone
- (618) 654-2107
- NPI assigned
- Sep 19, 2017
- 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 | 146012208 | IL | Primary |
Addresses
Primary practice location
1600 Lindenthal Ave
Highland, IL 62249-2203
Mailing address
400 Broadway
Highland, IL 62249-2024
Phone (618) 654-2106
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 |
|---|---|---|---|
| 146012208 | IL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1505779200000",
"number": "1194244301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 BROADWAY",
"city": "HIGHLAND",
"state": "IL",
"postal_code": "622492024",
"telephone_number": "618-654-2106"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 LINDENTHAL AVE",
"city": "HIGHLAND",
"state": "IL",
"postal_code": "622492203",
"telephone_number": "618-654-2107"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATRICK",
"first_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-09-19",
"last_updated": "2017-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "146012208",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Highland, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.