NPIMap

Organization Active NPI

Memorycare Corporation

  • Speech-Language Pathologist
  • Aurora, IL
National Provider Identifier
1609193515
Registry record updated Dec 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146.008945 Issued in IL
Legal business name
MEMORYCARE CORPORATION
Practice address
1057 Chadwick CT
Aurora, IL 60502-9323
Phone
(630) 800-2444
Fax
(773) 904-2361
NPI assigned
May 1, 2010
Last updated
Dec 4, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Rebecca M Khayum, M.S., CCC-SLP
Title
President
Phone
(773) 904-8447

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 146.008945 IL Primary

Addresses

Primary practice location

1057 Chadwick CT
Aurora, IL 60502-9323

Mailing address

1057 Chadwick CT
Aurora, IL 60502-9323
Phone (630) 800-2444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, TX, MT3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20101006000084 IL Part B Supplier - Clinic/Group Practice 3870785132 Receives reassigned benefits from 32 practitioners
Practice locations: Aurora, IL; Oakbrook Terrace, IL; Naperville, IL; Highland Park, IL; Chicago, IL
O20240815004276 TX Part B Supplier - Clinic/Group Practice 3870785132 Practice locations: Austin, TX
O20260109000836 MT Part B Supplier - Clinic/Group Practice 3870785132 Receives reassigned benefits from 1 practitioner
Practice locations: Bozeman, MT

National Provider Directory

National Provider Directory

Locations

3535 N Ashland Ave
Chicago, IL 60657
Phone (630) 217-9429

1936 Brookdale Rd
Naperville, IL 60563
Phone (630) 390-5597

Practitioners & affiliated clinicians

Practitioners 39

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1272672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670112000000",
    "number": "1609193515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1057 CHADWICK CT",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605029323",
            "telephone_number": "630-800-2444",
            "fax_number": "773-904-2361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1057 CHADWICK CT",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605029323",
            "telephone_number": "630-800-2444",
            "fax_number": "773-904-2361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORYCARE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-01",
        "last_updated": "2022-12-04",
        "certification_date": "2022-12-04",
        "status": "A",
        "authorized_official_last_name": "KHAYUM",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-904-8447",
        "authorized_official_credential": "M.S., CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.008945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.