Individual provider Active NPI

Rebekah Marie Kosco

  • Speech-Language Pathologist
  • Herrin, IL
National Provider Identifier
1306344247
Registry record updated Feb 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
242.004483 Issued in IL
Practice address
2315 N Park Ave
Herrin, IL 62948-3046
Phone
(618) 800-2335
NPI assigned
Jan 25, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2023

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 242.004483 IL Primary

Addresses

Primary practice location

2315 N Park Ave
Herrin, IL 62948-3046

Mailing address

606 E Il Highway 15
Mount Vernon, IL 62864-5072
Phone (618) 241-7039

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
242.004483ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1516838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676419200000",
    "number": "1306344247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 E IL HIGHWAY 15",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628645072",
            "telephone_number": "618-241-7039",
            "fax_number": "618-241-7039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 N PARK AVE",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629483046",
            "telephone_number": "618-800-2335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSCO",
        "first_name": "REBEKAH",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-25",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "242.004483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Herrin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2023; 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.