Active NPI
Marea Anne Rosedale, M.S.
- Speech-Language Pathologist
- South Elgin, IL
National Provider Identifier
1225389034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 242002466
- Practice address
- 759 Kane St
South Elgin, IL 60177-1418 - Phone
- (740) 632-5185
- NPI assigned
- Sep 20, 2012
- Sex
- Female
- 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 | 242002466 | IL | Primary |
Addresses
Primary practice location
759 Kane St
South Elgin, IL 60177-1418
Mailing address
759 Kane St
South Elgin, IL 60177-1418
Phone (630) 824-7765
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
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 242002466 | IL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489363200000",
"number": "1225389034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "759 KANE ST",
"city": "SOUTH ELGIN",
"state": "IL",
"postal_code": "601771418",
"telephone_number": "630-824-7765"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "759 KANE ST",
"city": "SOUTH ELGIN",
"state": "IL",
"postal_code": "601771418",
"telephone_number": "740-632-5185"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSEDALE",
"first_name": "MAREA",
"middle_name": "ANNE",
"credential": "M.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-09-20",
"last_updated": "2017-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "242002466",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Elgin, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.