Julia Debra Dettner

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146.016289 Issued in IL

Practice address

1500 N Clybourn Ave Unit C105
Chicago, IL 60610-2295

Phone

(312) 242-1665

NPI assigned

Dec 5, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Lumiere Children's Therapy, LLC

  • Developmental - Behavioral Pediatrics Physician
  • Chicago, IL
  • NPI 1497054050

  Speech-Language Pathologist

  NPD

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

{
    "created_epoch": "1638662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638662400000",
    "number": "1639837842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1457 N HALSTED ST APT 1102",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606422640",
            "telephone_number": "916-320-0577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N CLYBOURN AVE UNIT C105",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606102295",
            "telephone_number": "312-242-1665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETTNER",
        "first_name": "JULIA",
        "middle_name": "DEBRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-05",
        "last_updated": "2021-12-05",
        "certification_date": "2021-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.016289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jdettner@lumierechild.com",
            "affiliation": "Y",
            "endpointDescription": "email",
            "affiliationName": "Lumiere Children's Therapy",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1500 N Clybourn Ave Unit C105",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606102295",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Gina L Detmer, M.D.
• Wayne M Detmer, M.D.
• Joyce Detrich, LMT
• Deborah Lynn Dettman, LCSW, LICSW, SUDP
• Jamine L Dettmering, BCBA
• Linda Deubel, LCPC
• Jose Rafael Deurrutia, M.D.
• Todd David Deutch, M.D.
• David D. Deutsch, M.D.
• Monica Deutsch, DPT

• Speech-Language Pathologist in Chicago, IL
• Providers in Chicago, 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 Dec 5, 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.

Verify at the official NPI Registry.