Active NPI
Madisen Breunig, M.S. CF-SLP
- Speech-Language Pathologist
- Belleville, IL
National Provider Identifier
1629653175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2491198
- Practice address
- 840 Royal Heights Rd
Belleville, IL 62226-5798 - Phone
- (618) 234-8200
- NPI assigned
- Mar 16, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2491198 | IL | Primary |
Addresses
Primary practice location
840 Royal Heights Rd
Belleville, IL 62226-5798
Mailing address
840 Royal Heights Rd
Belleville, IL 62226-5798
Phone (618) 234-8200
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2491198 | IL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615852800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615852800000",
"number": "1629653175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "840 ROYAL HEIGHTS RD",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622265798",
"telephone_number": "618-234-8200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "840 ROYAL HEIGHTS RD",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622265798",
"telephone_number": "618-234-8200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BREUNIG",
"first_name": "MADISEN",
"credential": "M.S. CF-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-16",
"last_updated": "2021-03-16",
"certification_date": "2021-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "2491198",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Belleville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.