Stefanie Tyburczy

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

400 W Coady Dr
Minooka, IL 60447-9118

Phone

(815) 467-2261

NPI assigned

Oct 19, 2012

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Fantastic Speech & Language Therapy PLLC

  • Speech-Language Pathologist
  • Plainfield, IL
  • NPI 1124700240
  NPD Authorized official

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

{
    "created_epoch": "1350604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540771200000",
    "number": "1407109069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W COADY DR",
            "city": "MINOOKA",
            "state": "IL",
            "postal_code": "604479118",
            "telephone_number": "815-467-2261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W COADY DR",
            "city": "MINOOKA",
            "state": "IL",
            "postal_code": "604479118",
            "telephone_number": "815-467-2261"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1835 W Central Rd",
            "address_purpose": "LOCATION",
            "city": "Arlington Heights",
            "state": "IL",
            "postal_code": "600052410",
            "country_code": "US",
            "telephone_number": "847-870-7711",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6210 Black Hill Ridge Dr",
            "address_purpose": "LOCATION",
            "city": "Plainfield",
            "state": "IL",
            "postal_code": "605865629",
            "country_code": "US",
            "telephone_number": "815-919-6155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TYBURCZY",
        "first_name": "STEFANIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-19",
        "last_updated": "2018-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Chiropractic Place LLC
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• Sara Esther Torres
• Jennifer Lynn Truhlar, APRN
• Turtle Bloom Therapy, PLLC
• Samantha D Tyree, MA, LPC
• Danielle Renee Vanderploeg
• Laura Ann Viita, OT
• Nichole Lynne Wajda, SLPA
• Frances Wedge, PT

• Speech-Language Pathologist in Minooka, IL
• Providers in Minooka, IL by specialty
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2018; 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.