Elise Valerie O'Brien, M.A. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146004935 Issued in IL

Practice address

735 Chicago Ave
Apt 232
Evanston, IL 60202-2373

Phone

(312) 493-4716

NPI assigned

May 11, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Infant Welfare Society of Chicago

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1497872543

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1336694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1326307299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 CHICAGO AVE",
            "address_2": "APT 232",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602022373",
            "telephone_number": "312-493-4716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 CHICAGO AVE",
            "address_2": "APT 232",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602022373",
            "telephone_number": "312-493-4716"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3600 W Fullerton Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606472319",
            "country_code": "US",
            "telephone_number": "773-782-2800",
            "fax_number": "773-782-5042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "ELISE",
        "middle_name": "VALERIE",
        "credential": "M.A. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-11",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146004935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPEECH LANGUAGE PATHOLOGIST LICENSE",
            "identifier": "146004935",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "elise.o-brien.1@17986.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "3600 W Fullerton Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606472319",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Dan Joseph Nykaza, D.D.S.
• Bai Nyonly, CRNA
• O.T. to You Pediatric Therapy Services, LLC
• Kathryn O'Brien
• Michelle O'Connor
• Anne Marie O'Donnell
• Ashley O'Donnell, PT, DPT
• Ellen Talsky O'Donovan, LCPC

• Speech-Language Pathologist in Evanston, IL
• Providers in Evanston, IL by specialty
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.

Verify at the official NPI Registry.