Individual provider Active NPI

Lisa Lisowski-Leddy, MS,CCC-SLP

  • Speech-Language Pathologist
  • Glenview, IL
National Provider Identifier
1386788438
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146.003965 Issued in IL
Practice address
1716 Wildberry Dr Unit B
Glenview, IL 60025-1749
Phone
(773) 294-0639
Fax
(888) 408-8848
NPI assigned
Feb 19, 2007
Last updated
Dec 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

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 146.003965 IL Primary

Addresses

Primary practice location

1716 Wildberry Dr Unit B
Glenview, IL 60025-1749

Mailing address

1716 Wildberry Dr Unit B
Glenview, IL 60025-1749
Phone (773) 294-0639

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
146.003965ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Speech Services Unlimited, Inc. Current 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1386788438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1716 WILDBERRY DR UNIT B",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600251749",
            "telephone_number": "773-294-0639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1716 WILDBERRY DR UNIT B",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600251749",
            "telephone_number": "773-294-0639",
            "fax_number": "888-408-8848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISOWSKI-LEDDY",
        "first_name": "LISA",
        "name_prefix": "Miss",
        "credential": "MS,CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-19",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.003965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenview, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; 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.