Active NPI
Christine Ghazimoradi
- Speech-Language Pathologist
- Urbana, IL
National Provider Identifier
1376918698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 146012993
- Practice address
- 611 W. Park St.
Echo
Urbana, IL 61801-2500 - Phone
- (217) 326-2824
- NPI assigned
- Dec 11, 2015
- 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 Pathologist | 235Z00000X | 146012993 | IL | Primary |
Addresses
Primary practice location
611 W. Park St.
Echo
Urbana, IL 61801-2500
Mailing address
611 W. Park St.
BWPC
Urbana, IL 61801-2500
Phone (217) 383-6792
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146012993 | IL | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Foundation for Hearing Research, Inc. | Speech-Language Pathologist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Assistive Technology Practitioner Audiologist
- Redwood City, CA
- NPI 1891155115
Speech-Language Pathologist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1449792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1449792000000",
"number": "1376918698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "611 W. PARK ST.",
"address_2": "BWPC",
"city": "URBANA",
"state": "IL",
"postal_code": "618012500",
"telephone_number": "217-383-6792"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "611 W. PARK ST.",
"address_2": "ECHO",
"city": "URBANA",
"state": "IL",
"postal_code": "618012500",
"telephone_number": "217-326-2824"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GHAZIMORADI",
"first_name": "CHRISTINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-12-11",
"last_updated": "2015-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "146012993",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Urbana, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.