Individual provider Active NPI

Valerie Ann Doherty, M.A.

  • Speech-Language Pathologist
  • Evergreen Park, IL
National Provider Identifier
1306004593
Registry record updated May 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146001867 Issued in IL
Practice address
9658 S Ridgeway Ave
Evergreen Park, IL 60805-2952
Phone
(708) 829-6885
NPI assigned
May 25, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 146001867 IL Primary

Addresses

Primary practice location

9658 S Ridgeway Ave
Evergreen Park, IL 60805-2952

Mailing address

9658 S Ridgeway Ave
Evergreen Park, IL 60805-2952
Phone (708) 829-6885

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
146001867ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1211673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211673600000",
    "number": "1306004593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9658 S RIDGEWAY AVE",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052952",
            "telephone_number": "708-829-6885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9658 S RIDGEWAY AVE",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052952",
            "telephone_number": "708-829-6885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOHERTY",
        "first_name": "VALERIE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-25",
        "last_updated": "2008-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146001867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evergreen Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2008; 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.