Active NPI
Megan Wall
- Speech-Language Pathologist
- Crete, IL
National Provider Identifier
1639364102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Practice address
- 3545 Huntley Ter
Crete, IL 60417-1318 - Phone
- (708) 672-3653
- NPI assigned
- Sep 7, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | IL | Primary |
Addresses
Primary practice location
3545 Huntley Ter
Crete, IL 60417-1318
Mailing address
3545 Huntley Ter
Crete, IL 60417-1318
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
| License | State | Type | Specialty |
|---|---|---|---|
| 146009273 | IL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189123200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201651200000",
"number": "1639364102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3545 HUNTLEY TER",
"city": "CRETE",
"state": "IL",
"postal_code": "604171318"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3545 HUNTLEY TER",
"city": "CRETE",
"state": "IL",
"postal_code": "604171318",
"telephone_number": "708-672-3653"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALL",
"first_name": "MEGAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-09-07",
"last_updated": "2008-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crete, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.