Speech Language Fundamentals Inc

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146007330 Issued in IL

Legal business name

SPEECH LANGUAGE FUNDAMENTALS INC

Practice address

2923 198TH PL
Lynwood, IL 60411-4546

Phone

(708) 299-4799

NPI assigned

Nov 29, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Linda Marie Goforth, MHS CCC-SLP/L

Title

Director of Services/Owner

Phone

(708) 299-4799

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251331200000",
    "number": "1255408746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2923 198TH PL",
            "city": "LYNWOOD",
            "state": "IL",
            "postal_code": "604114546",
            "telephone_number": "708-299-4799",
            "fax_number": "708-849-6079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2923 198TH PL",
            "city": "LYNWOOD",
            "state": "IL",
            "postal_code": "604114546",
            "telephone_number": "708-299-4799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPEECH LANGUAGE FUNDAMENTALS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2009-08-27",
        "status": "A",
        "authorized_official_last_name": "GOFORTH",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "DIRECTOR OF SERVICES/OWNER",
        "authorized_official_telephone_number": "708-299-4799",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MHS CCC-SLP/L"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146007330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0001633463",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Lynwood, IL
• Providers in Lynwood, 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 Aug 27, 2009; 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.