Individual provider Active NPI

Madalene Jane Jorda, SLP

  • Speech-Language Pathologist
  • Crystal Lake, IL
National Provider Identifier
1508581182
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
242.006980 Issued in IL
Practice address
394 Federal Dr
Crystal Lake, IL 60014-6281
Phone
(815) 459-3810
NPI assigned
Oct 6, 2022
Last updated
Oct 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2022

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 242.006980 IL Primary

Addresses

Primary practice location

394 Federal Dr
Crystal Lake, IL 60014-6281

Mailing address

10511 Somerset LN
Huntley, IL 60142-2370
Phone (630) 549-5651

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
242.006980ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1665014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665014400000",
    "number": "1508581182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10511 SOMERSET LN",
            "city": "HUNTLEY",
            "state": "IL",
            "postal_code": "601422370",
            "telephone_number": "630-549-5651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "394 FEDERAL DR",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600146281",
            "telephone_number": "815-459-3810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDA",
        "first_name": "MADALENE",
        "middle_name": "JANE",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-06",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "242.006980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2022; 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.