Active NPI
Katie Boothe
- Speech-Language Pathologist
- Mokena, IL
National Provider Identifier
1609116789
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 242.002587
- Practice address
- 19100 Crescent Dr
Suite 101
Mokena, IL 60448-7510 - Phone
- (708) 478-5400
- NPI assigned
- Feb 26, 2013
- Last updated
- Feb 26, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 242.002587 | IL | Primary |
Addresses
Primary practice location
19100 Crescent Dr
Suite 101
Mokena, IL 60448-7510
Mailing address
19100 Crescent Dr
Suite 101
Mokena, IL 60448-7510
Phone (708) 478-5400
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
| License | State | Type | Specialty |
|---|---|---|---|
| 242.002587 | IL | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kids Can DO, Inc. | 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": "1361836800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361836800000",
"number": "1609116789",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19100 CRESCENT DR",
"address_2": "SUITE 101",
"city": "MOKENA",
"state": "IL",
"postal_code": "604487510",
"telephone_number": "708-478-5400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19100 CRESCENT DR",
"address_2": "SUITE 101",
"city": "MOKENA",
"state": "IL",
"postal_code": "604487510",
"telephone_number": "708-478-5400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOOTHE",
"first_name": "KATIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-02-26",
"last_updated": "2013-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "242.002587",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mokena, IL
- David Richard Blaski, OTR/L
- Jessica Lauren Blough, M.A., BCBA
- Body in Sync Physical Therapy, LTD. (Body in Sync Physical Therapy)
- Bone & Joint Surgeons, LTD
- Samantha Bonzani, FNP-BC
- Kerry Bouck
- Kathryn Boudouris, MS, OTR/L
- Tara Boyles
- Braden Partners LP (Pacific Pulmonary Services)
- Rachel Michelle Brauer Dever, NP-C
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.