Karen Lara Dudek-Brannan, ED.D. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146.008898 Issued in IL

Practice address

4 Holder Way
Bloomington, IL 61704-8152

Phone

(309) 212-4862

NPI assigned

Mar 28, 2007

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

Practice roles

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.

• Central Illinois Speech Therapy

  • Speech-Language Pathologist
  • Bloomington, IL
  • NPI 1962875872
  NPD (past) Authorized official

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504569600000",
    "number": "1528187697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 HOLDER WAY",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "61704",
            "telephone_number": "309-212-4862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 HOLDER WAY",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617048152",
            "telephone_number": "309-212-4862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDEK-BRANNAN",
        "first_name": "KAREN",
        "middle_name": "LARA",
        "name_prefix": "Dr.",
        "credential": "ED.D. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2017-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.008898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabriela C Doyle
• Dr Joseph F Rogge DC LTD
• Dream Wizards, PC
• DRS. Esch, Wieland and Naour, LLC
• Gregory R Dubois, CRNA
• Nancy G Duffy, LCSW
• Dui Solutions & Treatment Alternatives, Inc.
• Eric Duncan, MD
• Jason B Duncan, PSY.D.
• Kaitlyn N Duncan, APN

• Speech-Language Pathologist in Bloomington, IL
• Providers in Bloomington, 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 Sep 5, 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.