Individual provider Active NPI

Donrita Smith, CCC-SLP/L

  • Speech-Language Pathologist
  • Bolingbrook, IL
National Provider Identifier
1609282136
Registry record updated Jul 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146.007092 Issued in IL
Practice address
150 N Schmidt Rd
Bolingbrook, IL 60440-2689
Phone
(630) 759-9300
NPI assigned
Jul 4, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 4, 2014

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 146.007092 IL Primary

Addresses

Primary practice location

150 N Schmidt Rd
Bolingbrook, IL 60440-2689

Mailing address

489 Nassau Ave
Bolingbrook, IL 60440-2133
Phone (630) 739-5575

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
146.007092ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1404432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404432000000",
    "number": "1609282136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "489 NASSAU AVE",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604402133",
            "telephone_number": "630-739-5575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 N SCHMIDT RD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604402689",
            "telephone_number": "630-759-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DONRITA",
        "name_prefix": "Mrs.",
        "credential": "CCC-SLP/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-04",
        "last_updated": "2014-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.007092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolingbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2014; 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.