Pamela Pedziwiatr, SPEECH-LANGUAGE PATH

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146.002993 Issued in IL

Practice address

11411 183Rd St
Orland Park, IL 60467-9450

Phone

(708) 478-1820

Fax

(708) 231-7248

NPI assigned

Aug 21, 2016

Last updated

Aug 21, 2016By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1471737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471737600000",
    "number": "1346795275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11411 183RD ST",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604679450",
            "telephone_number": "708-478-1820",
            "fax_number": "708-231-7248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11411 183RD ST",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604679450",
            "telephone_number": "708-478-1820",
            "fax_number": "708-231-7248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDZIWIATR",
        "first_name": "PAMELA",
        "credential": "SPEECH-LANGUAGE PATH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-21",
        "last_updated": "2016-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.002993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF IL",
            "identifier": "146.002993",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Orland Park, IL
• Providers in Orland Park, 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 Aug 21, 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.