Individual provider Active NPI

Gabrielle Elaine Glim

  • Speech-Language Pathologist
  • Naperville, IL
National Provider Identifier
1205486388
Registry record updated Sep 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
242.005323 Issued in IL
Practice address
1400 Brookdale Rd
Naperville, IL 60563-2126
Phone
(630) 416-6565
NPI assigned
Sep 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2019

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 242.005323 IL Primary

Addresses

Primary practice location

1400 Brookdale Rd
Naperville, IL 60563-2126

Mailing address

7314 W Pueblo LN
Palos Heights, IL 60463-2621
Phone (708) 214-6463

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
242.005323ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1568851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568851200000",
    "number": "1205486388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7314 W PUEBLO LN",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604632621",
            "telephone_number": "708-214-6463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 BROOKDALE RD",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605632126",
            "telephone_number": "630-416-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLIM",
        "first_name": "GABRIELLE",
        "middle_name": "ELAINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-19",
        "last_updated": "2019-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "242.005323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2019; 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.