Active NPI
Colleen Marie Marvinac
- Speech-Language Pathologist
- Des Plaines, IL
National Provider Identifier
1497194039
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Practice address
- 950 Lee St Ste 210
Des Plaines, IL 60016-6574 - Phone
- (877) 486-4140
- NPI assigned
- Jun 17, 2013
- Last updated
- Sep 2, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | Primary | ||
| Behavior Analyst | 103K00000X |
Addresses
Primary practice location
950 Lee St Ste 210
Des Plaines, IL 60016-6574
Mailing address
1816 W Rice St Apt 1R
Chicago, IL 60622-6719
Other practice location 1
10700 Tower Dr
Orland Park, IL 60467-5483
Phone (708) 224-8090
Other practice location 2
917 Sherwood Dr Ste 201
Lake Bluff, IL 60044-2235
Phone (866) 815-6592
Other practice location 3
707 Lake Cook Rd Ste 314
Deerfield, IL 60015-4933
Phone (877) 486-4140
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1371427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599004800000",
"number": "1497194039",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1816 W RICE ST APT 1R",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606226719"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "950 LEE ST STE 210",
"city": "DES PLAINES",
"state": "IL",
"postal_code": "600166574",
"telephone_number": "877-486-4140"
}
],
"practiceLocations": [
{
"address_1": "10700 Tower Dr",
"address_purpose": "LOCATION",
"city": "Orland Park",
"state": "IL",
"postal_code": "604675483",
"country_code": "US",
"telephone_number": "708-224-8090",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "917 Sherwood Dr Ste 201",
"address_purpose": "LOCATION",
"city": "Lake Bluff",
"state": "IL",
"postal_code": "600442235",
"country_code": "US",
"telephone_number": "866-815-6592",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "707 Lake Cook Rd Ste 314",
"address_purpose": "LOCATION",
"city": "Deerfield",
"state": "IL",
"postal_code": "600154933",
"country_code": "US",
"telephone_number": "877-486-4140",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MARVINAC",
"first_name": "COLLEEN",
"middle_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-17",
"last_updated": "2020-09-02",
"certification_date": "2020-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": true
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Des Plaines, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.