Individual provider Active NPI

Caitlyn Boni

  • Speech-Language Pathologist
  • Glenview, IL
National Provider Identifier
1568077188
Registry record updated Sep 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
242006115 Issued in IL
Practice address
41 Waukegan Rd
Glenview, IL 60025-5154
Phone
(847) 707-6744
NPI assigned
Sep 10, 2020
Last updated
Sep 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2020

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 242006115 IL Primary

Addresses

Primary practice location

41 Waukegan Rd
Glenview, IL 60025-5154

Mailing address

41 Waukegan Rd
Glenview, IL 60025-5154
Phone (847) 707-6744

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
242006115ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Early Sprout Pediatric Therapy Current Accepting new patients
Little Steps Pediatric Physical Therapy, PC Speech-Language Pathologist PastSince Sep 13, 2020 Accepting new patients
Little Whale Therapy LLC Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1599696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599696000000",
    "number": "1568077188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 WAUKEGAN RD",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600255154",
            "telephone_number": "847-707-6744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 WAUKEGAN RD",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600255154",
            "telephone_number": "847-707-6744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONI",
        "first_name": "CAITLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-10",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "242006115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenview, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2020; 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.