Michael Gregory Congoran Jr., CCC-SLP/L

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146.013511 Issued in IL

Practice address

1031 5TH Ave
Belvidere, IL 61008-5139

Phone

(815) 544-3124

NPI assigned

Dec 11, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Empowerme Wellness Kansas City, LLC

  • Multi-Specialty Clinic/Center
  • Belleville, IL
  • NPI 1174118103

  Speech-Language Pathologist

  Medicare reassignment NPD
• Empowerme Rehabilitation Illinois, LLC

  • Occupational Therapist
  • Edwardsville, IL
  • NPI 1679098263

  Speech-Language Pathologist

  NPD
• Empowerme Rehabilitation Illinois, LLC

  • Rehabilitation Clinic/Center
  • Mount Carmel, IL
  • NPI 1962073734

  Speech-Language Pathologist

  NPD
• Empowerme Wellness Kansas City, LLC

  • Rehabilitation Clinic/Center
  • Liberty, MO
  • NPI 1174299044
  NPD

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

{
    "created_epoch": "1702252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1487421392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1031 5TH AVE",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "610085139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 5TH AVE",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "610085139",
            "telephone_number": "815-544-3124"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8201 E Riverside Blvd",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611142300",
            "country_code": "US",
            "telephone_number": "815-971-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONGORAN",
        "first_name": "MICHAEL",
        "middle_name": "GREGORY",
        "name_suffix": "Jr.",
        "credential": "CCC-SLP/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-11",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.013511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• CHW
• City of Belvidere (Metro Paramedic Services, Inc. DBA City of Belvidere)
• Clayton R. Malaker, M.D., S.C.
• Ronald Frederick Conder Sr., DDS
• Confident Smile Dental PC
• Nicole Connell
• Michael David Corcoran, D.P.M.
• Tanna Coss
• County of Boone (Boone County Health Department)
• Jennifer M Crotchett, MSW

• Speech-Language Pathologist in Belvidere, IL
• Providers in Belvidere, IL by specialty
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.