Individual provider Active NPI

Stephanie Rosen

  • Speech-Language Pathologist
  • Melrose Park, IL
National Provider Identifier
1578897369
Registry record updated Sep 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146008927 Issued in IL
Practice address
701 W North Ave
Rehab Services/Therapy
Melrose Park, IL 60160-1612
Phone
(708) 681-3200
NPI assigned
Sep 25, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2009

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 146008927 IL Primary

Addresses

Primary practice location

701 W North Ave
Rehab Services/Therapy
Melrose Park, IL 60160-1612

Mailing address

701 W North Ave
Rehab Services/Therapy
Melrose Park, IL 60160-1612
Phone (708) 681-3200

Other identifiers 1

IdentifierTypeStateIssuer
146008927OtherILST STATE LICENSE

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
146008927ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1253836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253836800000",
    "number": "1578897369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 W NORTH AVE",
            "address_2": "REHAB SERVICES/THERAPY",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601612",
            "telephone_number": "708-681-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 W NORTH AVE",
            "address_2": "REHAB SERVICES/THERAPY",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601612",
            "telephone_number": "708-681-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEN",
        "first_name": "STEPHANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-25",
        "last_updated": "2009-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146008927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ST STATE LICENSE",
            "identifier": "146008927",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melrose Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2009; 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.