Individual provider Active NPI

Debora M Roessler, MA CCC SLP

  • Speech-Language Pathologist
  • Chicago, IL
National Provider Identifier
1649344359
Registry record updated May 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146004994 Issued in IL
Practice address
3401 N Kildare Ave
Chicago, IL 60641-3831
Phone
(773) 742-3209
Fax
(773) 481-0023
NPI assigned
Nov 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 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 146004994 IL Primary

Addresses

Primary practice location

3401 N Kildare Ave
Chicago, IL 60641-3831

Mailing address

3401 N Kildare Ave
Chicago, IL 60641-3831
Phone (773) 742-3209

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)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
146004994ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212105600000",
    "number": "1649344359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 N KILDARE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606413831",
            "telephone_number": "773-742-3209",
            "fax_number": "773-481-0023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N KILDARE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606413831",
            "telephone_number": "773-742-3209",
            "fax_number": "773-481-0023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROESSLER",
        "first_name": "DEBORA",
        "middle_name": "M",
        "credential": "MA CCC SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2008-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146004994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

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

Verify at the official NPI Registry.