Individual provider Active NPI

Carolyn Ann Thielmann, M.S.

  • Speech-Language Pathologist
  • Mokena, IL
National Provider Identifier
1639320757
Registry record updated Oct 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
242.000823 Issued in IL
Practice address
19100 Crescent Dr
Suite 101
Mokena, IL 60448-7510
Phone
(708) 478-5400
NPI assigned
Oct 7, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2008

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 242.000823 IL Primary

Addresses

Primary practice location

19100 Crescent Dr
Suite 101
Mokena, IL 60448-7510

Mailing address

19869 Lakeview Way
Mokena, IL 60448-7716
Phone (708) 995-5128

Other names 1

  • Carolyn Ann Ryczek Former name

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

LicenseStateTypeSpecialty
242.000823ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kids Can DO, Inc. 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": "1223337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223337600000",
    "number": "1639320757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19869 LAKEVIEW WAY",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604487716",
            "telephone_number": "708-995-5128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19100 CRESCENT DR",
            "address_2": "SUITE 101",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604487510",
            "telephone_number": "708-478-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIELMANN",
        "first_name": "CAROLYN",
        "middle_name": "ANN",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-07",
        "last_updated": "2008-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "242.000823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLYN",
            "last_name": "RYCZEK",
            "middle_name": "ANN",
            "credential": "M.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mokena, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2008; 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.