Active NPI
Maureen Katherine Wangler, MS, CCC-SLP
- Speech-Language Pathologist
- Chicago, IL
National Provider Identifier
1518095041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 146.006718
- Practice address
- 1619 W Sunnyside Ave
Chicago, IL 60640-5907 - Phone
- (773) 456-1804
- NPI assigned
- Feb 28, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 146.006718 | IL | Primary |
Addresses
Primary practice location
1619 W Sunnyside Ave
Chicago, IL 60640-5907
Mailing address
1619 W Sunnyside Ave
Chicago, IL 60640-5907
Phone (773) 456-1804
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1635015 | Other | IL | BLUE CROSS BLUE SHIELD |
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146.006718 | IL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1251331200000",
"number": "1518095041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1619 W SUNNYSIDE AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606405907",
"telephone_number": "773-456-1804"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1619 W SUNNYSIDE AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606405907",
"telephone_number": "773-456-1804"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANGLER",
"first_name": "MAUREEN",
"middle_name": "KATHERINE",
"name_prefix": "Ms.",
"credential": "MS, CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-28",
"last_updated": "2009-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "146.006718",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "1635015",
"state": "IL"
}
],
"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 Aug 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.