Individual provider Active NPI

Miriam Ann Carroll-Alfano, SLP

  • Speech-Language Pathologist
  • Downers Grove, IL
National Provider Identifier
1356571806
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146.006653 Issued in IL
Practice address
3450 Lacey Rd
Downers Grove, IL 60515-5430
Phone
(630) 743-4500
NPI assigned
Jul 18, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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 146.006653 IL Primary

Addresses

Primary practice location

3450 Lacey Rd
Downers Grove, IL 60515-5430

Mailing address

555 31St St
Downers Grove, IL 60515-1235
Phone (630) 515-6428

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240916001580 IL Practitioner - Qualified Speech Language Pathologist 6608317839 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwestern UniversityGroup PAC ID 6305734773, 116 clinicians

Practice addresses (Care Compare)

3450 Lacey Rd
Downers Grove, IL 60515-5430
Phone (630) 743-4500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
146.006653ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Midwestern University CurrentSince Jun 24, 2024 Accepting new patients
Midwestern University Current Accepting new patients
Midwestern University Speech-Language Pathologist CurrentSince Jun 24, 2024 Accepting new patients
Midwestern University Past Accepting new patients

Locations

26520 Network Pl
Chicago, IL 60673
Phone (630) 743-4500

3450 Lacey Rd
Downers Grove, IL 60515
Phone (630) 743-4500

3450 Lacey Rd
Ste 602
Downers Grove, IL 60515
Phone (630) 743-4500

555 31st St
Downers Grove, IL 60515
Phone (630) 971-6080

3450 Lacey Rd
Ste 211
Downers Grove, IL 60515
Phone (630) 743-4500

Interoperability endpoints

  • FHIR API: https://epicproxy.et1329.epichosted.com/APIProxyPRD/HOME/api/FHIR/R4

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1247875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1356571806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 31ST ST",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151235",
            "telephone_number": "630-515-6428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 LACEY RD",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605155430",
            "telephone_number": "630-743-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL-ALFANO",
        "first_name": "MIRIAM",
        "middle_name": "ANN",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-18",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.006653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.