Individual provider Active NPI

Colleen Frances Wieland, SLP

  • Speech-Language Pathologist
  • Chicago, IL
National Provider Identifier
1306093752
Registry record updated Sep 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
001880 Issued in IL
Practice address
2300 N Childrens PLZ
Suite 701
Chicago, IL 60614-3363
Phone
(708) 836-8040
Fax
(708) 836-8040
NPI assigned
Aug 27, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2011

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 001880 IL Primary

Addresses

Primary practice location

2300 N Childrens PLZ
Suite 701
Chicago, IL 60614-3363

Mailing address

549 N Deer Run Dr
Palatine, IL 60067-8673
Phone (847) 997-1146

Other identifiers 1

IdentifierTypeStateIssuer
0665463MedicaidIA

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

State licenses

LicenseStateTypeSpecialty
001880ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Foundations First, LLC Speech-Language Pathologist CurrentSince Sep 15, 2024 Accepting new patients

Locations

585 W Cherry St
Ste A
North Liberty, IA 52317
Phone (319) 249-6925

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1219795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317340800000",
    "number": "1306093752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "549 N DEER RUN DR",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600678673",
            "telephone_number": "847-997-1146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 N CHILDRENS PLZ",
            "address_2": "SUITE 701",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606143363",
            "telephone_number": "708-836-8040",
            "fax_number": "708-836-8040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIELAND",
        "first_name": "COLLEEN",
        "middle_name": "FRANCES",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-27",
        "last_updated": "2011-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "001880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0665463",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2011; 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.