Individual provider Active NPI

Robin Wengrow, SLP/CCC

  • Speech-Language Pathologist
  • Chicago, IL
National Provider Identifier
1477878239
Registry record updated Oct 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
242001402 Issued in IL
Practice address
2948 W Birchwood Ave
Chicago, IL 60645-1220
Phone
(773) 754-7143
NPI assigned
Apr 5, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2021

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 242001402 IL Primary

Addresses

Primary practice location

2948 W Birchwood Ave
Chicago, IL 60645-1220

Mailing address

2948 W Birchwood Ave
Chicago, IL 60645-1220
Phone (773) 754-7143

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
242001402ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Braintrain Therapy LLC Speech-Language Pathologist CurrentSince Oct 10, 2021 Accepting new patients
Quality Therapy & Consultation, Inc. Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1270425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633651200000",
    "number": "1477878239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2948 W BIRCHWOOD AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606451220",
            "telephone_number": "773-754-7143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2948 W BIRCHWOOD AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606451220",
            "telephone_number": "773-754-7143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENGROW",
        "first_name": "ROBIN",
        "credential": "SLP/CCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-05",
        "last_updated": "2021-10-08",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "242001402",
            "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 Oct 8, 2021; 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.