Individual provider Active NPI

Erin Z Walta, MS, CF-SLP

  • Speech-Language Pathologist
  • La Grange, IL
National Provider Identifier
1558885129
Registry record updated Jul 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
242.004422 Issued in IL
Practice address
18 N Catherine Ave
La Grange, IL 60525-5930
Phone
(708) 482-9453
NPI assigned
Jul 26, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2017

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 242.004422 IL Primary

Addresses

Primary practice location

18 N Catherine Ave
La Grange, IL 60525-5930

Mailing address

7619 W 124TH PL
Palos Heights, IL 60463-1218
Phone (708) 601-7619

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
242.004422ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1501027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501027200000",
    "number": "1558885129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7619 W 124TH PL",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631218",
            "telephone_number": "708-601-7619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 N CATHERINE AVE",
            "city": "LA GRANGE",
            "state": "IL",
            "postal_code": "605255930",
            "telephone_number": "708-482-9453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTA",
        "first_name": "ERIN",
        "middle_name": "Z",
        "credential": "MS, CF-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-26",
        "last_updated": "2017-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "242.004422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Grange, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.