Active NPI
Serita Whitehorn
- Speech-Language Assistant
- Dolton, IL
National Provider Identifier
1194261875
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- 29001804A
- Practice address
- 509 E 144TH St
Dolton, IL 60419-1145 - Phone
- (773) 988-7883
- NPI assigned
- Jan 18, 2017
- Last updated
- Jan 18, 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 Assistant | 2355S0801X | 29001804A | IN | Primary |
Addresses
Primary practice location
509 E 144TH St
Dolton, IL 60419-1145
Mailing address
509 E 144TH St
Dolton, IL 60419-1145
Phone (773) 988-7883
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 |
|---|---|---|---|
| 29001804A | IN | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484697600000",
"number": "1194261875",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "509 E 144TH ST",
"city": "DOLTON",
"state": "IL",
"postal_code": "604191145",
"telephone_number": "773-988-7883"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "509 E 144TH ST",
"city": "DOLTON",
"state": "IL",
"postal_code": "604191145",
"telephone_number": "773-988-7883"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITEHORN",
"first_name": "SERITA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-01-18",
"last_updated": "2017-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "IN",
"license": "29001804A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dolton, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 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.