Individual provider Active NPI

Heather Brule, SPL

  • Speech-Language Pathologist
  • Rockford, IL
National Provider Identifier
1568673291
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146.006239 Issued in IL
Practice address
650 N Main St
Rockford, IL 61103-6921
Phone
(815) 965-6745
Fax
(815) 968-9563
NPI assigned
May 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 146.006239 IL Primary

Addresses

Primary practice location

650 N Main St
Rockford, IL 61103-6921

Mailing address

207 W Winnebago St
Winnebago, IL 61088-8584
Phone (815) 335-2352

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
146.006239ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1568673291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 W WINNEBAGO ST",
            "city": "WINNEBAGO",
            "state": "IL",
            "postal_code": "610888584",
            "telephone_number": "815-335-2352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 N MAIN ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611036921",
            "telephone_number": "815-965-6745",
            "fax_number": "815-968-9563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRULE",
        "first_name": "HEATHER",
        "name_prefix": "Mrs.",
        "credential": "SPL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.006239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, 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.

Verify at the official NPI Registry.