Anna M Rakowski, M.S. CCC-SLP/L

Key facts

NPI

1396259131

Entity type

Individual (NPI type 1)

Primary specialty

Speech-Language Pathologist 235Z00000X

License

146010316 (IL)

Practice address

170 S Wood Dale Rd
Wood Dale, IL 60191-2271

Phone

(630) 766-6336

NPI assigned

Nov 30, 2017

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Master of Science

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 30, 2017.

{
    "created_epoch": "1512000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512000000000",
    "number": "1396259131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7N186 GLEN RD",
            "city": "MEDINAH",
            "state": "IL",
            "postal_code": "601579636",
            "telephone_number": "847-414-3758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 S WOOD DALE RD",
            "city": "WOOD DALE",
            "state": "IL",
            "postal_code": "601912271",
            "telephone_number": "630-766-6336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAKOWSKI",
        "first_name": "ANNA",
        "middle_name": "M",
        "credential": "M.S. CCC-SLP/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-30",
        "last_updated": "2017-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146010316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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