Speech Suite 815

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

SPEECH SUITE 815

Practice address

838 1St St
La Salle, IL 61301-2508

Phone

(815) 200-8830

Fax

(815) 714-6202

NPI assigned

Oct 15, 2018

Organization subpart

No

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

Authorized official

Name

Mrs. Nicole Lucia Gedraitis, MHS, CCC-SLP/LNPI 1902034127

Title

Speech and Language Pathologist

Phone

(630) 229-7890

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nicole Lucia Gedraitis, MHS,CCC-SLP/L

  • Speech-Language Pathologist
  • Saint Charles, IL
  • NPI 1902034127
  NPD (past) Authorized official

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

{
    "created_epoch": "1539561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539561600000",
    "number": "1366918682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 MARY SENICA CT",
            "city": "LA SALLE",
            "state": "IL",
            "postal_code": "613019658",
            "telephone_number": "630-229-7890",
            "fax_number": "815-714-6202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "838 1ST ST",
            "city": "LA SALLE",
            "state": "IL",
            "postal_code": "613012508",
            "telephone_number": "815-200-8830",
            "fax_number": "815-714-6202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPEECH SUITE 815",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-15",
        "last_updated": "2018-10-15",
        "status": "A",
        "authorized_official_last_name": "GEDRAITIS",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "LUCIA",
        "authorized_official_title_or_position": "SPEECH AND LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "630-229-7890",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MHS, CCC-SLP/L"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE INSURANCE",
            "identifier": "1902034127",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paige Scoma
• Shawn Wayne Slagle, LCSW
• Noelle Sliker, L.C.S.W.
• Abbey Slusarski, LCSW
• Patrick R Smith, DC
• St. Margaret'S Health-Peru
• St. Margaret'S Health-Peru
• St. Margaret'S Health-Peru
• St. Margaret'S Health-Peru
• Mark M. Stahnke, M.DIV.

• Speech-Language Pathologist in La Salle, IL
• Providers in La Salle, 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 Oct 15, 2018; 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.