Individual provider Active NPI

Julia Kirwan, CCC/SLP/L

  • Speech-Language Pathologist
  • Springfield, IL
National Provider Identifier
1316218845
Registry record updated Jul 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA14611 Issued in FL
Practice address
2601 Montvale Dr
Springfield, IL 62704-4200
Phone
(217) 303-5803
Fax
(217) 303-5804
NPI assigned
Jan 13, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 146.002169 IL
Speech-Language Pathologist 235Z00000X SA14611 FL Primary

Addresses

Primary practice location

2601 Montvale Dr
Springfield, IL 62704-4200

Mailing address

327 W Mason St
Springfield, IL 62702-5019
Phone (630) 913-1140

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
SA14611FLMDSpeech-Language Pathologist
146.002169ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1326412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468540800000",
    "number": "1316218845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "327 W MASON ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627025019",
            "telephone_number": "630-913-1140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 MONTVALE DR",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044200",
            "telephone_number": "217-303-5803",
            "fax_number": "217-303-5804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRWAN",
        "first_name": "JULIA",
        "name_prefix": "Ms.",
        "credential": "CCC/SLP/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-13",
        "last_updated": "2016-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.002169",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA14611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2016; 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.