Individual provider Active NPI

Stephanie Nicole Boron

  • Speech-Language Pathologist
  • Skokie, IL
National Provider Identifier
1215375506
Registry record updated Jun 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
242002528 Issued in IL
Practice address
9833 Woods Dr
Skokie, IL 60077-1104
Phone
(847) 443-1020
NPI assigned
Jun 7, 2013
Last updated
Jun 7, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2013

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 242002528 IL Primary

Addresses

Primary practice location

9833 Woods Dr
Skokie, IL 60077-1104

Mailing address

9833 Woods Dr
Skokie, IL 60077-1104
Phone (847) 443-1020

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
242002528ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1370563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370563200000",
    "number": "1215375506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9833 WOODS DR",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771104",
            "telephone_number": "847-443-1020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9833 WOODS DR",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771104",
            "telephone_number": "847-443-1020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORON",
        "first_name": "STEPHANIE",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-07",
        "last_updated": "2013-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "242002528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2013; 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.