Vanessa Granato-Wagner, M.S., CCC-SLP/L

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146.008357 Issued in IL

Practice address

6020 151St St
Oak Forest, IL 60452-1841

Phone

(708) 687-0900

NPI assigned

Nov 27, 2017

Sex

Female

Sole proprietor

No

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)

Not enrolled

Credentials

Master of Science

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.

• Southwest Cook County Cooperative Assn for Special Education

  • Local Education Agency (LEA)
  • Oak Forest, IL
  • NPI 1962680009
  NPD (past)

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

{
    "created_epoch": "1511740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511740800000",
    "number": "1275047417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7652 166TH PL",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604772416",
            "telephone_number": "708-415-8102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6020 151ST ST",
            "city": "OAK FOREST",
            "state": "IL",
            "postal_code": "604521841",
            "telephone_number": "708-687-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANATO-WAGNER",
        "first_name": "VANESSA",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC-SLP/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-27",
        "last_updated": "2017-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.008357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mathew George, M.D.
• Meena S George, M.D., PH.D.
• Joyce Gertzen, M.D.
• Valerie Jean Gill-Taylor, DEVLOPMENTAL THERAPI
• Tamara Jeanne Good
• Chaya Grant, FNP-C
• Barbara L Grevengoed, LCPC
• Lena T Halikias
• Daniel Halkin, P.T.
• Thomas Michael Halwax, D.C.

• Speech-Language Pathologist in Oak Forest, IL
• Providers in Oak Forest, 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 Nov 27, 2017; 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.