Lisa Marie Gardner, M.S, CCC-SLP/L

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

216023 Issued in MA

Practice address

547 S Clark St Apt 305
Chicago, IL 60605-1546

Phone

(781) 424-4123

NPI assigned

Jan 7, 2013

Last updated

Jan 7, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Thrive Speech and Feeding Therapy

  • Clinic/Center
  • Chicago, IL
  • NPI 1568248904
  Authorized official Same address or phone
• Rush University Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1932213600
  NPD

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

{
    "created_epoch": "1357516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357516800000",
    "number": "1245577535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "547 S CLARK ST APT 305",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606051546",
            "telephone_number": "781-424-4123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "547 S CLARK ST APT 305",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606051546",
            "telephone_number": "781-424-4123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "M.S, CCC-SLP/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-07",
        "last_updated": "2013-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MA",
            "license": "216023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ena M. Gardner
• Jill R. Gardner, PH.D.
• Kasey Gardner, MD
• Lacresha Tenisha Marie Gardner
• Leslie Gardner, CNM, APN
• Mary Gardner, PSY.D.
• Megan Gardner
• Michele Carla Gardner, L.S.W.
• Michelle Gardner, APRN
• Novella Gardner, PHARMD

• Speech-Language Pathologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Speech-Language Pathologist in Illinois

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