Individual provider Active NPI

Lesley Caroline Milam

  • Speech-Language Pathologist
  • Chenoa, IL
National Provider Identifier
1649649906
Registry record updated Sep 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
242003649 Issued in IL
Practice address
24588 Church St
Chenoa, IL 61726-9395
Phone
(309) 747-2702
NPI assigned
Sep 16, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2015

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 242003649 IL Primary

Addresses

Primary practice location

24588 Church St
Chenoa, IL 61726-9395

Mailing address

108 N Blair Dr
Normal, IL 61761-1816

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211005000915 IL Practitioner - Qualified Speech Language Pathologist 9032517198 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
At Home by Enhance Therapies LLCGroup PAC ID 4183033210, 44 clinicians

Practice addresses (Care Compare)

1701 Evergreen Blvd
Normal, IL 61761-7802
Phone (732) 994-3200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
242003649ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
At Home by Enhance Therapies LLC Speech-Language Pathologist CurrentSince Dec 27, 2024 Accepting new patients

Locations

7358 N Lincoln Ave
Ste 160
Lincolnwood, IL 60712
Phone (847) 983-8750

1701 Evergreen Blvd
Normal, IL 61761
Phone (309) 451-9355

400 Route 70
Lakewood, NJ 08701
Phone (732) 802-7512

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1442361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442361600000",
    "number": "1649649906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 N BLAIR DR",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617611816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24588 CHURCH ST",
            "city": "CHENOA",
            "state": "IL",
            "postal_code": "617269395",
            "telephone_number": "309-747-2702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILAM",
        "first_name": "LESLEY",
        "middle_name": "CAROLINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-16",
        "last_updated": "2015-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "242003649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chenoa, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.