Kelley Bowers Laesch, M.A., CCC-SLP/L

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146.003244 Issued in IL

Practice address

425 S Knollwood Dr
Wheaton, IL 60187-4734

Phone

(630) 462-3676

Fax

(630) 462-3676

NPI assigned

Jul 21, 2016

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1469059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469059200000",
    "number": "1649623927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 S KNOLLWOOD DR",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601874734",
            "telephone_number": "630-462-3676",
            "fax_number": "630-462-3676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 S KNOLLWOOD DR",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601874734",
            "telephone_number": "630-462-3676",
            "fax_number": "630-462-3676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAESCH",
        "first_name": "KELLEY",
        "middle_name": "BOWERS",
        "name_prefix": "Ms.",
        "credential": "M.A., CCC-SLP/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-21",
        "last_updated": "2016-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.003244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Wheaton, IL
• Providers in Wheaton, 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 Jul 21, 2016; 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.