Individual provider Active NPI

Jessica Philipp, CCC-SLP

  • Speech-Language Pathologist
  • Evanston, IL
National Provider Identifier
1194436154
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
1704 Maple Ave Ste 110
Evanston, IL 60201-3134
Phone
(630) 933-1500
Fax
(224) 271-5556
NPI assigned
Dec 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X IL Primary

Addresses

Primary practice location

1704 Maple Ave Ste 110
Evanston, IL 60201-3134

Mailing address

1704 Maple Ave Ste 110
Evanston, IL 60201-3134
Phone (630) 933-1500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250618000278 IL Practitioner - Qualified Speech Language Pathologist 0648781484 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians

Practice addresses (Care Compare)

1704 Maple Ave
Suite 110
Evanston, IL 60201-3134
Phone (630) 933-1500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Jun 10, 2025 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jun 10, 2025 Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

1630 Sherman Ave
#100
Evanston, IL 60201

1704 Maple Ave
Ste 110
Evanston, IL 60201

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

660 N Westmoreland Rd
Lake Forest, IL 60045
Phone (847) 535-6100

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1670803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1194436154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1704 MAPLE AVE STE 110",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602013134",
            "telephone_number": "630-933-1500",
            "fax_number": "224-271-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1704 MAPLE AVE STE 110",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602013134",
            "telephone_number": "630-933-1500",
            "fax_number": "224-271-5556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILIPP",
        "first_name": "JESSICA",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-12",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.