Individual provider Active NPI

Julia Megan Ecclestone, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Chicago, IL
National Provider Identifier
1508014192
Registry record updated Sep 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146.009437 Issued in IL
Practice address
345 E Superior St
Chicago, IL 60611-2654
Phone
(312) 238-1000
NPI assigned
Sep 8, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2008

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 146.009437 IL Primary

Addresses

Primary practice location

345 E Superior St
Chicago, IL 60611-2654

Mailing address

14 W Elm St
Apt. 1307
Chicago, IL 60610-7132
Phone (517) 974-5044

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
146.009437ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1220832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220832000000",
    "number": "1508014192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 W ELM ST",
            "address_2": "APT. 1307",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606107132",
            "telephone_number": "517-974-5044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 E SUPERIOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112654",
            "telephone_number": "312-238-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECCLESTONE",
        "first_name": "JULIA",
        "middle_name": "MEGAN",
        "name_prefix": "Ms.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-08",
        "last_updated": "2008-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.009437",
            "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 Sep 8, 2008; 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.