Active NPI
Brianna Caitlin Maki, CCC-SLP
- Speech-Language Pathologist
- Waukegan, IL
National Provider Identifier
1265041958
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 097243
- Practice address
- 901 N Lewis Ave
Waukegan, IL 60085-2626 - Phone
- (224) 303-3700
- NPI assigned
- Jul 28, 2020
- Sex
- Female
- Sole proprietor
- No
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 | 097243 | IA | Primary |
Addresses
Primary practice location
901 N Lewis Ave
Waukegan, IL 60085-2626
Mailing address
1201 N Sheridan Rd
Waukegan, IL 60085-2081
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
| License | State | Type | Specialty |
|---|---|---|---|
| 097243 | IA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595894400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691539200000",
"number": "1265041958",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1201 N SHERIDAN RD",
"city": "WAUKEGAN",
"state": "IL",
"postal_code": "600852081"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 N LEWIS AVE",
"city": "WAUKEGAN",
"state": "IL",
"postal_code": "600852626",
"telephone_number": "224-303-3700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAKI",
"first_name": "BRIANNA",
"middle_name": "CAITLIN",
"credential": "CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-28",
"last_updated": "2023-08-09",
"certification_date": "2023-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IA",
"license": "097243",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waukegan, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.