Active NPI
Tracy Ann Muller, MS SLP CCC
- Speech-Language Pathologist
- Petersburg, IL
National Provider Identifier
1386840700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Practice address
- 748 Persimmon Rd
Petersburg, IL 62675-9554 - Phone
- (217) 632-2632
- NPI assigned
- Jun 22, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | IL | Primary |
Addresses
Primary practice location
748 Persimmon Rd
Petersburg, IL 62675-9554
Mailing address
748 Persimmon Rd
Petersburg, IL 62675-9554
Phone (217) 632-2632
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
| License | State | Type | Specialty |
|---|---|---|---|
| 146.005172 | IL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1386840700",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "748 PERSIMMON RD",
"city": "PETERSBURG",
"state": "IL",
"postal_code": "626759554",
"telephone_number": "217-632-2632"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "748 PERSIMMON RD",
"city": "PETERSBURG",
"state": "IL",
"postal_code": "626759554",
"telephone_number": "217-632-2632"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULLER",
"first_name": "TRACY",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "MS SLP CCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Petersburg, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.