Individual provider Active NPI

Denise Ann Prohaska, SLP-CCC

  • Speech-Language Pathologist
  • Oak Lawn, IL
National Provider Identifier
1619467719
Registry record updated May 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146.000038 Issued in IL
Practice address
10317 Mason Ave
Oak Lawn, IL 60453-4399
Phone
(708) 250-6232
NPI assigned
May 14, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 146.000038 IL Primary

Addresses

Primary practice location

10317 Mason Ave
Oak Lawn, IL 60453-4399

Mailing address

10317 Mason Ave
Oak Lawn, IL 60453-4399
Phone (708) 250-6232

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
146.000038ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1526256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526256000000",
    "number": "1619467719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10317 MASON AVE",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604534399",
            "telephone_number": "708-250-6232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10317 MASON AVE",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604534399",
            "telephone_number": "708-250-6232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROHASKA",
        "first_name": "DENISE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "SLP-CCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-14",
        "last_updated": "2018-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.000038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2018; 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.