Organization Active NPI

Kind Word Speech Pathology

  • Speech-Language Pathologist
  • Libertyville, IL
National Provider Identifier
1609199538
Registry record updated Mar 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146000775 Issued in IL
Legal business name
KIND WORD SPEECH PATHOLOGY
Practice address
704 S Dymond Rd
Libertyville, IL 60048-3028
Phone
(847) 571-5044
Fax
(847) 549-1347
NPI assigned
Mar 5, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2010

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

Authorized official

Name
Karin Richter
Title
Billing Service
Phone
(847) 769-5316

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 146000775 IL Primary

Addresses

Primary practice location

704 S Dymond Rd
Libertyville, IL 60048-3028

Mailing address

704 S Dymond Rd
Libertyville, IL 60048-3028
Phone (847) 571-5044

Other identifiers 1

IdentifierTypeStateIssuer
342542154001MedicaidIL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1267747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267747200000",
    "number": "1609199538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 S DYMOND RD",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483028",
            "telephone_number": "847-571-5044",
            "fax_number": "847-549-1347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 S DYMOND RD",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483028",
            "telephone_number": "847-571-5044",
            "fax_number": "847-549-1347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIND WORD SPEECH PATHOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-05",
        "last_updated": "2010-03-05",
        "status": "A",
        "authorized_official_last_name": "RICHTER",
        "authorized_official_first_name": "KARIN",
        "authorized_official_title_or_position": "BILLING SERVICE",
        "authorized_official_telephone_number": "847-769-5316"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146000775",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "342542154001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2010; 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.