Individual provider Active NPI

Kristine Michelle Bowen

  • Speech-Language Pathologist
  • Orland Park, IL
National Provider Identifier
1396040820
Registry record updated Jan 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146009791 Issued in IL
Practice address
11411 W 183Rd St
Orland Park, IL 60467-9450
Phone
(708) 478-1820
Fax
(708) 478-1331
NPI assigned
Jan 13, 2011
Last updated
Jan 13, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2011

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 146009791 IL Primary

Addresses

Primary practice location

11411 W 183Rd St
Orland Park, IL 60467-9450

Mailing address

9712 S 51St Ave
Oak Lawn, IL 60453-3051
Phone (708) 478-1820

Other identifiers 1

IdentifierTypeStateIssuer
09932114OtherILBLUE CROSS BLUE SHIEDL

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

State licenses

LicenseStateTypeSpecialty
146009791ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1294876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294876800000",
    "number": "1396040820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9712 S 51ST AVE",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604533051",
            "telephone_number": "708-478-1820",
            "fax_number": "708-478-3316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11411 W 183RD ST",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604679450",
            "telephone_number": "708-478-1820",
            "fax_number": "708-478-1331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWEN",
        "first_name": "KRISTINE",
        "middle_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-13",
        "last_updated": "2011-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146009791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIEDL",
            "identifier": "09932114",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2011; 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.