Karen Ill

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP5035 Issued in CA

Practice address

1098 Oceanic Dr
Encinitas, CA 92024-4005

Phone

(760) 815-2143

NPI assigned

Feb 23, 2016

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

Other names 1

• Karen Ill Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Associated Speech Pathologists

  • Speech-Language Pathologist
  • San Marcos, CA
  • NPI 1225167646
  NPD (past)

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

{
    "created_epoch": "1456185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456185600000",
    "number": "1265891949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1595 GRAND AVE",
            "address_2": "SUITE 110",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920782450",
            "telephone_number": "760-471-1198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1098 OCEANIC DR",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920244005",
            "telephone_number": "760-815-2143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILL",
        "first_name": "KAREN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-23",
        "last_updated": "2016-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP5035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAREN",
            "last_name": "ILL",
            "credential": "M.S.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Speech-Language Pathologist in Encinitas, CA
• Providers in Encinitas, CA by specialty
• Speech-Language Pathologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2016; 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.