Individual provider Active NPI

Patrice Smetana

  • Speech-Language Pathologist
  • North Riverside, IL
National Provider Identifier
1497238968
Registry record updated Sep 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1190819 Issued in IL
Practice address
8940 W 24TH St
North Riverside, IL 60546-1158
Phone
(708) 447-8030
NPI assigned
Sep 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2018

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 1190819 IL Primary

Addresses

Primary practice location

8940 W 24TH St
North Riverside, IL 60546-1158

Mailing address

111 S Morgan St Apt 809
Chicago, IL 60607-2735
Phone (815) 592-3080

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
1190819ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Komarek School District 94 Past Accepting new patients

Organizations & group practices 1

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": "1536624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536624000000",
    "number": "1497238968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S MORGAN ST APT 809",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606072735",
            "telephone_number": "815-592-3080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8940 W 24TH ST",
            "city": "NORTH RIVERSIDE",
            "state": "IL",
            "postal_code": "605461158",
            "telephone_number": "708-447-8030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMETANA",
        "first_name": "PATRICE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-11",
        "last_updated": "2018-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "1190819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Riverside, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2018; 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.