Active NPI
Colleen Frances Wieland, SLP
- Speech-Language Pathologist
- Chicago, IL
National Provider Identifier
1306093752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 001880
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0665463 | Medicaid | IA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 001880 | IL | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Foundations First, LLC | Speech-Language Pathologist | Current | 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.
-
- Speech-Language Pathologist
- North Liberty, IA
- NPI 1083440267
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.