Caitlyn Patalas, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

242007616 Issued in IL

Practice address

10110 Old Lincoln Trail
Fairview Heights, IL 62208

Phone

(618) 397-2764

NPI assigned

Aug 14, 2024

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.

• Grant Community School District 110

  • Local Education Agency (LEA)
  • Fairview Heights, IL
  • NPI 1649492133
  NPD (past)

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

{
    "created_epoch": "1723593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1295567881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8441 E JACKSON STREET RD",
            "city": "DU QUOIN",
            "state": "IL",
            "postal_code": "628323810",
            "telephone_number": "618-571-2232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10110 OLD LINCOLN TRAIL",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "62208",
            "telephone_number": "618-397-2764"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21 Circle Dr",
            "address_purpose": "LOCATION",
            "city": "Fairview Heights",
            "state": "IL",
            "postal_code": "622081103",
            "country_code": "US",
            "telephone_number": "618-398-5552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATALAS",
        "first_name": "CAITLYN",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-14",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "242007616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyler Christine Owens, LCSW
• Beth M Pacocha Auer, PT, MPT
• Ty Parker, DMD
• Takiera S Parnell
• Federico Parola, M.ED, M.A.
• Pearle Vision Inc
• Peterson Health Clinic LLC
• Hannah Peterson, BT
• Ronald Gene Peterson Jr., D.C.
• Isabella Pfeiffer

• Speech-Language Pathologist in Fairview Heights, IL
• Providers in Fairview Heights, 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 14, 2024; 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.