Morgan Rae Hentzel

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

242005318 Issued in IL

Practice address

315 N Bonham St
Macomb, IL 61455-1808

Phone

(309) 833-2095

NPI assigned

Aug 6, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Morgan Rae Weirather Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1565049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565049600000",
    "number": "1629623764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1027 DERRY LN APT 54",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "614552683",
            "telephone_number": "319-795-0990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 N BONHAM ST",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "614551808",
            "telephone_number": "309-833-2095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENTZEL",
        "first_name": "MORGAN",
        "middle_name": "RAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-06",
        "last_updated": "2019-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "242005318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MORGAN",
            "last_name": "WEIRATHER",
            "middle_name": "RAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Alana Hendrixson, PT, DPT
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• Highland Park CVS LLC
• Amy Renee Hofmeister, MSED, LCPC

• Speech-Language Pathologist in Macomb, IL
• Providers in Macomb, IL by specialty
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2019; 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.