Active NPI
Jessica Wilcox
- Speech-Language Pathologist
- Chicago, IL
National Provider Identifier
1528252798
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SLP006500
- Practice address
- 1620 N Lasalle St
Chicago, IL 60614-6005 - Phone
- (312) 943-3600
- NPI assigned
- Aug 30, 2007
- Last updated
- Jun 28, 2024
- Sex
- Female
- Sole proprietor
- No
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 | SLP006500 | GA | Primary |
Addresses
Primary practice location
1620 N Lasalle St
Chicago, IL 60614-6005
Mailing address
60 Maple Leaf Rd
Sharpsburg, GA 30277-2397
Phone (312) 339-2805
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240723001985 | GA | Practitioner - Qualified Speech Language Pathologist | 7113463498 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SLP006500 | GA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719532800000",
"number": "1528252798",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "60 MAPLE LEAF RD",
"city": "SHARPSBURG",
"state": "GA",
"postal_code": "302772397",
"telephone_number": "312-339-2805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1620 N LASALLE ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606146005",
"telephone_number": "312-943-3600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILCOX",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-30",
"last_updated": "2024-06-28",
"certification_date": "2024-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "GA",
"license": "SLP006500",
"primary": true
}
],
"identifiers": [],
"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 Jun 28, 2024; 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.