Individual provider Active NPI

Jordyn Morris

  • Speech-Language Pathologist
  • Machesney Park, IL
National Provider Identifier
1518486398
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146013645 Issued in IL
Practice address
710 Ralston Rd
Machesney Park, IL 61115
Phone
(815) 654-4559
NPI assigned
Sep 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 146013645 IL Primary

Addresses

Primary practice location

710 Ralston Rd
Machesney Park, IL 61115

Mailing address

710 Ralston Rd
Machesney Park, IL 61115-1569

Other practice location 1

808 Harlem Rd
Machesney Park, IL 61115-2514
Phone (815) 654-4559

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
146013645ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1505260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1518486398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 RALSTON RD",
            "city": "MACHESNEY PARK",
            "state": "IL",
            "postal_code": "611151569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 RALSTON RD",
            "city": "MACHESNEY PARK",
            "state": "IL",
            "postal_code": "61115",
            "telephone_number": "815-654-4559"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "808 Harlem Rd",
            "address_purpose": "LOCATION",
            "city": "Machesney Park",
            "state": "IL",
            "postal_code": "611152514",
            "country_code": "US",
            "telephone_number": "815-654-4559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORRIS",
        "first_name": "JORDYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-13",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146013645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Machesney Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.