Grace Dean
Individual provider Active NPI Speech-Language Pathologist · Forest Park, IL
NPI 1295416865 · NPPES record last updated Jul 27, 2023
Key facts
- NPI
- 1295416865
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 242.007430 (IL)
- Practice address
- 7423 Madison St
Forest Park, IL 60130-1502 - Phone
- (779) 348-0364
- NPI assigned
- Jul 27, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 242.007430 | IL | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 242.007430 | IL | Yes |
Addresses
Primary practice location
7423 Madison St
Forest Park, IL 60130-1502
Mailing address
7423 Madison St
Forest Park, IL 60130-1502
NPI Registry JSON
{
"created_epoch": "1690416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690416000000",
"number": "1295416865",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7423 MADISON ST",
"city": "FOREST PARK",
"state": "IL",
"postal_code": "601301502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7423 MADISON ST",
"city": "FOREST PARK",
"state": "IL",
"postal_code": "601301502",
"telephone_number": "779-348-0364"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEAN",
"first_name": "GRACE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-27",
"last_updated": "2023-07-27",
"certification_date": "2023-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "242.007430",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forest Park, IL
- Maria Cruz
- Sophia E. Dabney
- Elizabeth Daley
- Chrishunda Davis
- Meshal Davis
- Beverly L Deck
- Barbara Decker
- Meghan Dee
- Ariana Delgado
- Victoria Katerina Delis
All providers in Forest Park, IL · Speech-Language Pathologist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.