Individual provider Active NPI

Brette Fiedelman, C-SLPA

  • Speech-Language Assistant
  • Chicago, IL
National Provider Identifier
1194492108
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
217000410 Issued in IL
Practice address
3048 N Milwaukee Ave
Chicago, IL 60618-6624
Phone
(773) 595-6786
NPI assigned
Aug 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X 217000410 IL Primary

Addresses

Primary practice location

3048 N Milwaukee Ave
Chicago, IL 60618-6624

Mailing address

1906 W Foster Ave Apt 2
Chicago, IL 60640-1026
Phone (224) 848-9630

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

LicenseStateTypeSpecialty
217000410ILMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1629936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1194492108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1906 W FOSTER AVE APT 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606401026",
            "telephone_number": "224-848-9630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3048 N MILWAUKEE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606186624",
            "telephone_number": "773-595-6786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIEDELMAN",
        "first_name": "BRETTE",
        "credential": "C-SLPA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-26",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "IL",
            "license": "217000410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.