Individual provider Active NPI

Pamela Kooi, SLP

  • Speech-Language Pathologist
  • Wheaton, IL
National Provider Identifier
1588030530
Registry record updated Jan 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146001553 Issued in IL
Practice address
1725 S Naperville Rd Ste 110
Wheaton, IL 60189-5855
Phone
(630) 793-8404
NPI assigned
Aug 13, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2019

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 146001553 IL Primary

Addresses

Primary practice location

1725 S Naperville Rd Ste 110
Wheaton, IL 60189-5855

Mailing address

1209 Runyan Dr
Lockport, IL 60441-3807
Phone (815) 931-8353

Other practice location 1

1419 Essington Rd
Joliet, IL 60435-2873
Phone (815) 729-2160

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
146001553ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Westside Childrens Therapy Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 1

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": "1439424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547596800000",
    "number": "1588030530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1209 RUNYAN DR",
            "city": "LOCKPORT",
            "state": "IL",
            "postal_code": "604413807",
            "telephone_number": "815-931-8353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 S NAPERVILLE RD STE 110",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601895855",
            "telephone_number": "630-793-8404"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1419 Essington Rd",
            "address_purpose": "LOCATION",
            "city": "Joliet",
            "state": "IL",
            "postal_code": "604352873",
            "country_code": "US",
            "telephone_number": "815-729-2160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOOI",
        "first_name": "PAMELA",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-13",
        "last_updated": "2019-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146001553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2019; 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.