Tara S Sample, MHSCCCSLP L

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

346 Alana Dr
New Lenox, IL 60451-1784

Phone

(815) 462-0514

Fax

(815) 462-3993

NPI assigned

Feb 14, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• At Home by Enhance Therapies LLC

  • Physical Therapist
  • Lakewood, NJ
  • NPI 1124603246

  IL, Speech-Language Pathologist

  Medicare reassignment NPD
• Kid Talk Inc

  • Speech-Language Pathologist
  • New Lenox, IL
  • NPI 1295726164
  NPD (past)

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508909375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1095 JAMES PASS",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604513148",
            "telephone_number": "815-483-8535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "346 ALANA DR",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604511784",
            "telephone_number": "815-462-0514",
            "fax_number": "815-462-3993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMPLE",
        "first_name": "TARA",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "MHSCCCSLP L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "9932126",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASHA",
            "identifier": "09138770",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• S & S Doctor LTD
• Sarah M Sabatino
• Catherine C Sajn, OD
• Rania Hafeth Saleh, M.D.
• April Sales
• Alexandria Sams
• Rita L Sanders, LPC
• Felicia L. Sanford, PSYD, HSPP
• Abdul Sankari, M.D.
• Leesa Ann Sasic-Mitsos, DDS PC

• Speech-Language Pathologist in New Lenox, IL
• Providers in New Lenox, IL by specialty
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.