Individual provider Active NPI

Michele Petrone, M.A CCC-SLP/L

  • Speech-Language Pathologist
  • Chicago, IL
National Provider Identifier
1447435011
Registry record updated Sep 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146009253 Issued in IL
Practice address
6155 N Overhill Ave
Chicago, IL 60631-1850
Phone
(773) 750-1468
NPI assigned
Jan 2, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 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 146009253 IL Primary

Addresses

Primary practice location

6155 N Overhill Ave
Chicago, IL 60631-1850

Mailing address

6155 N Overhill Ave
Chicago, IL 60631-1850
Phone (773) 750-1468

Other names 1

  • Michele Hermann Former name

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
146009253ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1199232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315958400000",
    "number": "1447435011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6155 N OVERHILL AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606311850",
            "telephone_number": "773-750-1468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6155 N OVERHILL AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606311850",
            "telephone_number": "773-750-1468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRONE",
        "first_name": "MICHELE",
        "name_prefix": "Mrs.",
        "credential": "M.A CCC-SLP/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-02",
        "last_updated": "2011-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146009253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELE",
            "last_name": "HERMANN",
            "credential": "M.A CCC-SLP/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Sep 14, 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.