Individual provider Active NPI

Karen M. Willis, SLP-P

  • Speech-Language Assistant
  • Saint Anne, IL
National Provider Identifier
1487977740
Registry record updated Mar 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
217.000207 Issued in IL
Practice address
9887 E 8000S Rd
Saint Anne, IL 60964-4615
Phone
(815) 422-0457
NPI assigned
Mar 1, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X 217.000207 IL Primary

Addresses

Primary practice location

9887 E 8000S Rd
Saint Anne, IL 60964-4615

Mailing address

9887 E 8000S Rd
Saint Anne, IL 60964-4615
Phone (815) 422-0457

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
217.000207ILMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1267401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267401600000",
    "number": "1487977740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9887 E 8000S RD",
            "city": "SAINT ANNE",
            "state": "IL",
            "postal_code": "609644615",
            "telephone_number": "815-422-0457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9887 E 8000S RD",
            "city": "SAINT ANNE",
            "state": "IL",
            "postal_code": "609644615",
            "telephone_number": "815-422-0457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "KAREN",
        "middle_name": "M.",
        "name_prefix": "Mrs.",
        "credential": "SLP-P",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-01",
        "last_updated": "2010-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "IL",
            "license": "217.000207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Anne, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2010; 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.