Active NPI
Mary Elizabeth Huizinga, M.S., CF-SLP
- Speech-Language Pathologist
- Orland Park, IL
National Provider Identifier
1629687173
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 242.005751
- Practice address
- 14711 S Ravinia Ave
Orland Park, IL 60462-3100 - Phone
- (815) 469-1500
- NPI assigned
- Jul 29, 2020
- 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 | 242.005751 | IL | Primary |
Addresses
Primary practice location
14711 S Ravinia Ave
Orland Park, IL 60462-3100
Mailing address
14711 S Ravinia Ave
Orland Park, IL 60462-3100
Phone (815) 469-1500
Other practice location 1
750 Essington Rd
Joliet, IL 60435-4912
Phone (815) 729-2160
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 |
|---|---|---|---|
| 242.005751 | IL | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Westside Childrens Therapy | Speech-Language Pathologist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596067200000",
"number": "1629687173",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14711 S RAVINIA AVE",
"city": "ORLAND PARK",
"state": "IL",
"postal_code": "604623100",
"telephone_number": "815-469-1500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14711 S RAVINIA AVE",
"city": "ORLAND PARK",
"state": "IL",
"postal_code": "604623100",
"telephone_number": "815-469-1500"
}
],
"practiceLocations": [
{
"address_1": "750 Essington Rd",
"address_purpose": "LOCATION",
"city": "Joliet",
"state": "IL",
"postal_code": "604354912",
"country_code": "US",
"telephone_number": "815-729-2160",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HUIZINGA",
"first_name": "MARY",
"middle_name": "ELIZABETH",
"credential": "M.S., CF-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-29",
"last_updated": "2020-07-30",
"certification_date": "2020-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "242.005751",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orland Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.