Individual provider Active NPI

Kathryn A Selvage, SLP

  • Speech-Language Pathologist
  • Orland Park, IL
National Provider Identifier
1457575219
Registry record updated Mar 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146008505 Issued in IL
Practice address
16170 Kingsport Rd
Orland Park, IL 60467-5602
Phone
(708) 349-6544
NPI assigned
Apr 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 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 146008505 IL Primary

Addresses

Primary practice location

16170 Kingsport Rd
Orland Park, IL 60467-5602

Mailing address

9912 Austin Ave
Oak Lawn, IL 60453-3728
Phone (708) 529-3789

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300752000000",
    "number": "1457575219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9912 AUSTIN AVE",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604533728",
            "telephone_number": "708-529-3789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16170 KINGSPORT RD",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604675602",
            "telephone_number": "708-349-6544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELVAGE",
        "first_name": "KATHRYN",
        "middle_name": "A",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2011-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146008505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 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.