Individual provider Active NPI

Jessica Conway, MS CCC-SLP

  • Speech-Language Pathologist
  • Chicago, IL
National Provider Identifier
1255147997
Registry record updated Dec 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146.015037 Issued in IL
Practice address
1051 N Wolcott Ave Apt 2
Chicago, IL 60622-0151
Phone
(513) 633-5180
NPI assigned
Dec 7, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2024

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 146.015037 IL Primary

Addresses

Primary practice location

1051 N Wolcott Ave Apt 2
Chicago, IL 60622-0151

Mailing address

1051 N Wolcott Ave Apt 2
Chicago, IL 60622-0151
Phone (513) 633-5180

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, TN, GA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20241216001486 IL Practitioner - Qualified Speech Language Pathologist 3577099423 Reassigns benefits to 1 organization
I20250228002884 TN Practitioner - Qualified Speech Language Pathologist 3577099423 Reassigns benefits to 1 organization
I20250303002824 GA Practitioner - Qualified Speech Language Pathologist 3577099423 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
9074TNMDPharmacist
146.015037ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Expressable Speech-Language Pathology, P.C. Speech-Language Pathologist CurrentSince Feb 7, 2025 Accepting new patients
Expressable Therapy PC Speech-Language Pathologist CurrentSince Mar 3, 2025 Accepting new patients

Locations

633 W 5th St
Los Angeles, CA 90071
Phone (213) 260-1286

5555 Glenridge Connector
Ste 200
Sandy Springs, GA 30342
Phone (404) 459-2516

5555 Glenridge Connector
Sandy Springs, GA 30342
Phone (202) 276-9478

5 Revere Dr
#One
Northbrook, IL 60062

5 Revere Dr
Ste 200
Northbrook, IL 60062
Phone (630) 291-3206

40 Burton Hills Blvd
Ste 200
Nashville, TN 37215
Phone (615) 257-8410

7600 Chevy Chase Dr
Ste 300
Austin, TX 78752
Phone (512) 318-2503

7600 Chevy Chase Dr
Austin, TX 78752
Phone (512) 649-3880

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1733529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733529600000",
    "number": "1255147997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 N WOLCOTT AVE APT 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606220151",
            "telephone_number": "513-633-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 N WOLCOTT AVE APT 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606220151",
            "telephone_number": "513-633-5180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONWAY",
        "first_name": "JESSICA",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-07",
        "last_updated": "2024-12-07",
        "certification_date": "2024-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.015037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.