Active NPI
Heather Michelini
- Speech-Language Pathologist
- Peoria, IL
National Provider Identifier
1407232093
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 242.003393
- Practice address
- 1417 W Columbia Ter
Peoria, IL 61606-1104 - Phone
- (314) 686-8110
- NPI assigned
- Aug 5, 2015
- Last updated
- Nov 9, 2017
- Sex
- Female
- Sole proprietor
- No
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 | 242.003393 | IL | Primary |
Addresses
Primary practice location
1417 W Columbia Ter
Peoria, IL 61606-1104
Mailing address
1417 W Columbia Ter
Peoria, IL 61606-1104
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
| License | State | Type | Specialty |
|---|---|---|---|
| 242.003393 | IL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1510185600000",
"number": "1407232093",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1417 W COLUMBIA TER",
"city": "PEORIA",
"state": "IL",
"postal_code": "616061104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1417 W COLUMBIA TER",
"city": "PEORIA",
"state": "IL",
"postal_code": "616061104",
"telephone_number": "314-686-8110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICHELINI",
"first_name": "HEATHER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-05",
"last_updated": "2017-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "242.003393",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peoria, IL
- MFG Counseling Services. LLC
- Michael D. Cashman, M.D., S.C.
- Michael D. Tarantino, M.D. S.C.
- Michael E Longevin MDSC
- Jon Christopher Michel, MD
- Paulo Roberto Kossatz Michelini
- Michelle Matzke Therapy, PLLC (Healing Blooms Therapy)
- Matthew Robert Michels
- Mid Illini Surgical Associates SC
- Kristen Middendorf, OTR/L
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.