Individual provider Active NPI

Suzanne Katherine McLane, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Grayslake, IL
National Provider Identifier
1366622763
Registry record updated Jul 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146009007 Issued in IL
Practice address
33197 N Sears Blvd
Grayslake, IL 60030-2177
Phone
(847) 370-2177
NPI assigned
Nov 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 001814 IA
Speech-Language Pathologist 235Z00000X 146009007 IL Primary

Addresses

Primary practice location

33197 N Sears Blvd
Grayslake, IL 60030-2177

Mailing address

33197 N Sears Blvd
Grayslake, IL 60030-2177
Phone (847) 370-2177

Other identifiers 1

IdentifierTypeStateIssuer
0665711MedicaidIA

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
001814IAMDSpeech-Language Pathologist
146009007ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343088000000",
    "number": "1366622763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33197 N SEARS BLVD",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600302177",
            "telephone_number": "847-370-2177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33197 N SEARS BLVD",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600302177",
            "telephone_number": "847-370-2177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLANE",
        "first_name": "SUZANNE",
        "middle_name": "KATHERINE",
        "name_prefix": "Mrs.",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-14",
        "last_updated": "2012-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IA",
            "license": "001814",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146009007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0665711",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grayslake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2012; 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.