Active NPI
Susanna Mari Vargas, PHD , CCC-SLP
- Speech-Language Pathologist
- Chicago, IL
National Provider Identifier
1417287202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 1460009989
- Practice address
- 4316 N Troy St
Chicago, IL 60618-1306 - Phone
- (812) 219-8864
- NPI assigned
- Dec 30, 2009
- 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 | 1460009989 | IL | Primary |
Addresses
Primary practice location
4316 N Troy St
Chicago, IL 60618-1306
Mailing address
4316 N Troy St
Chicago, IL 60618-1306
Phone (812) 219-8864
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1460009989 | IL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1262131200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1417287202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4316 N TROY ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606181306",
"telephone_number": "812-219-8864"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4316 N TROY ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606181306",
"telephone_number": "812-219-8864"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VARGAS",
"first_name": "SUSANNA",
"middle_name": "MARI",
"name_prefix": "Ms.",
"credential": "PHD , CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-12-30",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "1460009989",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.