Mallory Large

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146.012244 Issued in IL

Practice address

11053 S Millard Ave
Chicago, IL 60655-3327

Phone

(773) 253-9856

NPI assigned

Oct 6, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1507248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507248000000",
    "number": "1518477363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9049 FAIRWAY DR",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604622717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11053 S MILLARD AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606553327",
            "telephone_number": "773-253-9856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARGE",
        "first_name": "MALLORY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-06",
        "last_updated": "2017-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.012244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alfred F Larcher Jr., DC
• Robert Lardner, P.T.
• Erin Marie Lareau, M.D.
• Olivia A Lares, D.D.S.
• Mackenzie Kathryn Large, OD
• Karen Ann Larimer, ACNP-BC
• Erick Larios Bautista, MD
• Aurorita Estur Lariosa, MD
• Charisma Lariosa, PT
• Ashley Larisey, M.S. CCC-SLP

• Speech-Language Pathologist in Chicago, IL
• Providers in Chicago, 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 Oct 6, 2017; 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.