Individual provider Active NPI

Amanda Lederer, MA, CCC-SLP

  • Speech-Language Pathologist
  • Chicago, IL
National Provider Identifier
1457691743
Registry record updated Nov 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
145011896 Issued in IL
Practice address
469 W Huron St
1010
Chicago, IL 60654-3467
Phone
(201) 294-4929
NPI assigned
Feb 22, 2013
Last updated
Nov 10, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2016

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 242002115 IL
Speech-Language Pathologist 235Z00000X 145011896 IL Primary

Addresses

Primary practice location

469 W Huron St
1010
Chicago, IL 60654-3467

Mailing address

469 W Huron St
1010
Chicago, IL 60654-3467
Phone (201) 294-4929

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
145011896ILMDSpeech-Language Pathologist
242002115ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Soundbox, LLC Speech-Language Pathologist Current Accepting new patients

Locations

8 S Michigan Ave
Ste 2100
Chicago, IL 60603
Phone (312) 344-1081

Organizations & group practices 1

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": "1361491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478736000000",
    "number": "1457691743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "469 W HURON ST",
            "address_2": "1010",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606543467",
            "telephone_number": "201-294-4929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "469 W HURON ST",
            "address_2": "1010",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606543467",
            "telephone_number": "201-294-4929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDERER",
        "first_name": "AMANDA",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-22",
        "last_updated": "2016-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "242002115",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "145011896",
            "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 Nov 10, 2016; 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.