Active NPI
Jan Marsden-Johnson
- Speech-Language Pathologist
- Deerfield, IL
National Provider Identifier
1538176672
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Practice address
- 1181 Lake Cook Rd Ste a
Deerfield, IL 60015-5201 - Phone
- (847) 964-2003
- NPI assigned
- Aug 2, 2006
- Last updated
- Jul 8, 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 | IL | Primary |
Addresses
Primary practice location
1181 Lake Cook Rd Ste a
Deerfield, IL 60015-5201
Mailing address
707 Westgate Rd
Deerfield, IL 60015-3136
Phone (847) 964-2003
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01634785 | 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146-003335 | IL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1538176672",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "707 WESTGATE RD",
"city": "DEERFIELD",
"state": "IL",
"postal_code": "600153136",
"telephone_number": "847-964-2003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1181 LAKE COOK RD STE A",
"city": "DEERFIELD",
"state": "IL",
"postal_code": "600155201",
"telephone_number": "847-964-2003"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARSDEN-JOHNSON",
"first_name": "JAN",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "01634785",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Deerfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.