Individual provider Active NPI

Leigh E Shea, MA CCC-SLP

  • Speech-Language Pathologist
  • Westchester, IL
National Provider Identifier
1437480944
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146.009906 Issued in IL
Practice address
3075 Wolf Rd
Westchester, IL 60154-5622
Phone
(708) 223-8011
NPI assigned
Jan 22, 2010
Last updated
Jun 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2021

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 146.009906 IL Primary

Addresses

Primary practice location

3075 Wolf Rd
Westchester, IL 60154-5622

Mailing address

3075 Wolf Rd
Westchester, IL 60154-5622
Phone (708) 223-8011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191223000706 IL Practitioner - Qualified Speech Language Pathologist 0648604884 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Impulse Rehab and Wellness PLLCGroup PAC ID 4688905995, 7 clinicians
Midwestern UniversityGroup PAC ID 6305734773, 116 clinicians

Practice addresses (Care Compare)

3075 S Wolf Rd
Westchester, IL 60154-5622
Phone (708) 223-8011

3450 Lacey Rd
Downers Grove, IL 60515-5430
Phone (630) 743-4500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
146.009906ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Impulse Rehab and Wellness, PLLC Speech-Language Pathologist CurrentSince Nov 4, 2019 Accepting new patients
Midwestern University CurrentSince May 15, 2021 Accepting new patients
Midwestern University CurrentSince May 15, 2021 Accepting new patients
Midwestern University Past Accepting new patients

Locations

26520 Network Pl
Chicago, IL 60673
Phone (630) 743-4500

3450 Lacey Rd
Downers Grove, IL 60515
Phone (630) 743-4500

3450 Lacey Rd
Ste 211
Downers Grove, IL 60515
Phone (630) 743-4500

3450 Lacey Rd
Ste 602
Downers Grove, IL 60515
Phone (630) 743-4500

3075 Wolf Rd
Westchester, IL 60154
Phone (708) 223-8011

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1264118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1437480944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3075 WOLF RD",
            "city": "WESTCHESTER",
            "state": "IL",
            "postal_code": "601545622",
            "telephone_number": "708-223-8011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3075 WOLF RD",
            "city": "WESTCHESTER",
            "state": "IL",
            "postal_code": "601545622",
            "telephone_number": "708-223-8011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEA",
        "first_name": "LEIGH",
        "middle_name": "E",
        "credential": "MA CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-22",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.009906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westchester, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.