Edwige Charles

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146015176 Issued in IL

Practice address

15206 Naughton Dr
South Holland, IL 60473-1115

Phone

(708) 299-9714

NPI assigned

Feb 23, 2017

Last updated

Aug 2, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1487808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1194265124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 RHODE ISLAND AVE NE",
            "address_2": "SUITE I",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200021269",
            "telephone_number": "202-575-5404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15206 NAUGHTON DR",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604731115",
            "telephone_number": "708-299-9714"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "680 Rhode Island Ave NE",
            "address_2": "Suite I",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200021269",
            "country_code": "US",
            "telephone_number": "202-575-5404",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15206 Naughton Dr",
            "address_purpose": "LOCATION",
            "city": "South Holland",
            "state": "IL",
            "postal_code": "604731115",
            "country_code": "US",
            "telephone_number": "708-299-9714",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "EDWIGE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-23",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "DC",
            "license": "SLP001072",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146015176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in South Holland, IL
• Providers in South Holland, IL by specialty
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 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.

Verify at the official NPI Registry.