Individual provider Active NPI

Mary J Wrobel, MA/CCC SLP

  • Speech-Language Pathologist
  • Sycamore, IL
National Provider Identifier
1427413541
Registry record updated Dec 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146.002656 Issued in IL
Practice address
1225 E State St
Sycamore, IL 60178-9502
Phone
(815) 219-3040
NPI assigned
Dec 16, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 146.002656 IL Primary
Speech-Language Pathologist 235Z00000X 146.002665 IL

Addresses

Primary practice location

1225 E State St
Sycamore, IL 60178-9502

Mailing address

861 Lakeside Dr
Bartlett, IL 60103-4748
Phone (630) 837-5977

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
Master of Arts

State licenses

LicenseStateTypeSpecialty
146.002656ILMDSpeech-Language Pathologist
146.002665ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1450224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450224000000",
    "number": "1427413541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "861 LAKESIDE DR",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601034748",
            "telephone_number": "630-837-5977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 E STATE ST",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601789502",
            "telephone_number": "815-219-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WROBEL",
        "first_name": "MARY",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "MA/CCC SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-16",
        "last_updated": "2015-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.002656",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.002665",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sycamore, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2015; 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.