Amanda Nathanson, MS CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146016792 Issued in IL

Practice address

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

Phone

(312) 242-1665

NPI assigned

Apr 8, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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": "1712534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1649023870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 BURNSIDE CT",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611403",
            "telephone_number": "224-723-0770"
        },
        {
            "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": "NATHANSON",
        "first_name": "AMANDA",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-08",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146016792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• R Deva Nathan, MD
• Sandeep Nathan
• Shayna Nathan, APN-CNP
• Sunita Nathan, M.D.
• Ruth Shanika Nathaniel
• Frances Irene Nathanson, LCSW
• Dhara Nathwani, MA
• Ari Simon Natinsky
• National Diagnostics Lab Inc
• National Medical Care Inc

• 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 Apr 8, 2024; 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.