Individual provider Active NPI

Mandi J Sawlaw, SLP

  • Speech-Language Pathologist
  • Pekin, IL
National Provider Identifier
1407141898
Registry record updated Sep 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146010260 Issued in IL
Practice address
2988 Court St
Pekin, IL 61554-6229
Phone
(309) 353-5940
Fax
(309) 353-1654
NPI assigned
Jun 14, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 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 146010260 IL Primary

Addresses

Primary practice location

2988 Court St
Pekin, IL 61554-6229

Mailing address

2988 Court St
Pekin, IL 61554-6229
Phone (309) 353-5940

Other identifiers 1

IdentifierTypeStateIssuer
P00957005OtherILRR MEDICARE

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Therapy Services, Inc Speech-Language Pathologist PastSince Aug 1, 2012 Accepting new patients
Brendon J Johnson, OD, PC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1308009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317340800000",
    "number": "1407141898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2988 COURT ST",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615546229",
            "telephone_number": "309-353-5940",
            "fax_number": "309-353-1654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2988 COURT ST",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615546229",
            "telephone_number": "309-353-5940",
            "fax_number": "309-353-1654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAWLAW",
        "first_name": "MANDI",
        "middle_name": "J",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-14",
        "last_updated": "2011-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146010260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00957005",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pekin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.