Individual provider Active NPI

Marnelle Kathryn Oligschlaeger, CCC-SLP

  • Speech-Language Pathologist
  • Shelbyville, IL
National Provider Identifier
1467963512
Registry record updated Oct 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146.004987 Issued in IL
Practice address
1101 WN 6TH St
Shelbyville, IL 62565
Phone
(217) 774-2169
NPI assigned
Oct 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2017

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 146.004987 IL Primary

Addresses

Primary practice location

1101 WN 6TH St
Shelbyville, IL 62565

Mailing address

1322 County Highway 30
Shelbyville, IL 62565-4453
Phone (217) 827-3865

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

State licenses

LicenseStateTypeSpecialty
146.004987ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1508198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508198400000",
    "number": "1467963512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1322 COUNTY HIGHWAY 30",
            "city": "SHELBYVILLE",
            "state": "IL",
            "postal_code": "625654453",
            "telephone_number": "217-827-3865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 WN 6TH ST",
            "city": "SHELBYVILLE",
            "state": "IL",
            "postal_code": "62565",
            "telephone_number": "217-774-2169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIGSCHLAEGER",
        "first_name": "MARNELLE",
        "middle_name": "KATHRYN",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-17",
        "last_updated": "2017-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.004987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelbyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2017; 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.