Active NPI
Elizy Smith, SLP
- Speech-Language Assistant
- Hazel Crest, IL
National Provider Identifier
1356688550
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- 242.002555
- Practice address
- 3309 Charlemagne Ave
Hazel Crest, IL 60429-2224 - Phone
- (708) 829-0832
- NPI assigned
- Jan 8, 2013
- Last updated
- Jan 8, 2013
- 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 Assistant | 2355S0801X | 242.002555 | IL | Primary |
Addresses
Primary practice location
3309 Charlemagne Ave
Hazel Crest, IL 60429-2224
Mailing address
3309 Charlemagne Ave
Hazel Crest, IL 60429-2224
Phone (708) 829-0832
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 |
|---|---|---|---|
| 242.002555 | IL | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1357603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357603200000",
"number": "1356688550",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3309 CHARLEMAGNE AVE",
"city": "HAZEL CREST",
"state": "IL",
"postal_code": "604292224",
"telephone_number": "708-829-0832"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3309 CHARLEMAGNE AVE",
"city": "HAZEL CREST",
"state": "IL",
"postal_code": "604292224",
"telephone_number": "708-829-0832"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "ELIZY",
"name_prefix": "Ms.",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-01-08",
"last_updated": "2013-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "IL",
"license": "242.002555",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hazel Crest, IL
- Desarey Sims, NP
- Tessa Singer, RD
- Tanyalak Sivabovorn, M.D.
- Skylight Ascend Wellness, PLLC
- Smith Thomas-Williams Healthcare, LLC (STW Home Health)
- Wanda Denise Smith, CPSYC HCPROF
- Sole 2 Sole, PC (Dr. Eveleigh Williams)
- Jack Lamont Solomon Jr.
- South Suburban Senior Socialites, Inc
- Southwest Eye Center, S.C.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.