Active NPI
Anthony George Mlcoch, PH.D.
- Speech-Language Pathologist
- Hines, IL
National Provider Identifier
1215032974
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Practice address
- 5TH and Roosevelt Ave
Audiology and Speech Pathology (126)
Hines, IL 60141 - Phone
- (708) 202-8387
- Fax
- (708) 202-2105
- NPI assigned
- Sep 14, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 Pathologist | 235Z00000X | IL | Primary |
Addresses
Primary practice location
5TH and Roosevelt Ave
Audiology and Speech Pathology (126)
Hines, IL 60141
Mailing address
5TH and Roosevelt Ave
Audiology and Speech Pathology (126)
Hines, IL 60141
Phone (708) 202-8387
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146.002365 | IL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1215032974",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5TH AND ROOSEVELT AVE",
"address_2": "AUDIOLOGY AND SPEECH PATHOLOGY (126)",
"city": "HINES",
"state": "IL",
"postal_code": "60141",
"telephone_number": "708-202-8387",
"fax_number": "708-202-2105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5TH AND ROOSEVELT AVE",
"address_2": "AUDIOLOGY AND SPEECH PATHOLOGY (126)",
"city": "HINES",
"state": "IL",
"postal_code": "60141",
"telephone_number": "708-202-8387",
"fax_number": "708-202-2105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MLCOCH",
"first_name": "ANTHONY",
"middle_name": "GEORGE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hines, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.