Organization Active NPI

Lakeview Speech and Language Clinic, LLC

  • Pediatric Occupational Therapist
  • Oak Park, IL
National Provider Identifier
1457710063
Registry record updated Feb 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
56009800 Issued in IL
Legal business name
LAKEVIEW SPEECH AND LANGUAGE CLINIC, LLC
Practice address
822 N Cuyler Ave
Oak Park, IL 60302-1408
Phone
(773) 573-7709
NPI assigned
Feb 11, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2016

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

Authorized official

Name
Tracy Trumbell, MA, CCC-SLP
Title
Owner
Phone
(773) 573-7709

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XP0200X 56009800 IL Primary

Addresses

Primary practice location

822 N Cuyler Ave
Oak Park, IL 60302-1408

Mailing address

822 N Cuyler Ave
Oak Park, IL 60302-1408
Phone (773) 573-7709

National Provider Directory

National Provider Directory
Tax ID family
Lakeview Speech and Language Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1455148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455148800000",
    "number": "1457710063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "822 N CUYLER AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603021408",
            "telephone_number": "773-573-7709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 N CUYLER AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603021408",
            "telephone_number": "773-573-7709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEVIEW SPEECH AND LANGUAGE CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-11",
        "last_updated": "2016-02-11",
        "status": "A",
        "authorized_official_last_name": "TRUMBELL",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-573-7709",
        "authorized_official_credential": "MA, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "IL",
            "license": "56009800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.