Active NPI
Michelle Diatte
- Speech-Language Pathologist
- Springfield, IL
National Provider Identifier
1316614209
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 146.015975
- Practice address
- 3130 Chatham Rd Ste a
Springfield, IL 62704-5379 - Phone
- (815) 725-9992
- Fax
- (847) 713-3995
- NPI assigned
- Aug 27, 2021
- 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 | 146.015975 | IL | Primary |
Addresses
Primary practice location
3130 Chatham Rd Ste a
Springfield, IL 62704-5379
Mailing address
PO Box 631278
Cincinnati, OH 45263-1278
Phone (815) 725-9992
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 |
|---|---|---|---|
| 146.015975 | IL | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Speech Tree Associates, LLC | Speech-Language Pathologist | Current | Accepting new patients |
| Autism Home Support Services, Inc | Speech-Language Pathologist | Past | Accepting new patients |
| In2Great | Speech-Language Pathologist | Past | Accepting new patients |
Locations
3130 Chatham Rd
Ste A
Springfield, IL 62704
Phone (815) 725-9992
Organizations & group practices 3
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
- Springfield, IL
- NPI 1578794558
-
- Behavior Analyst
- Northbrook, IL
- NPI 1770818841
Speech-Language Pathologist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630022400000",
"number": "1316614209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 631278",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452631278",
"telephone_number": "815-725-9992",
"fax_number": "847-713-3995"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3130 CHATHAM RD STE A",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627045379",
"telephone_number": "815-725-9992",
"fax_number": "847-713-3995"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIATTE",
"first_name": "MICHELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-27",
"last_updated": "2021-08-27",
"certification_date": "2021-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "146.015975",
"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 Aug 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.