Abigail Andersen Boursiquot, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146.015797 Issued in IL

Practice address

2869 N Lincoln Ave
Chicago, IL 60657-4201

Phone

(733) 665-9947

NPI assigned

Jun 5, 2018

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

Specialty

Qualified Speech Language Pathologist

Education

George Washington University School of Medicine, 2018

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Physical Therapy Renaissance LTD

  • Physical Therapist
  • Chicago, IL
  • NPI 1790886307
  NPD
• Wellness by Physiatry, PLLC

  • Physical Medicine & Rehabilitation Physician
  • Chicago, IL
  • NPI 1255123584
  NPD
• Partum Health Service Corporation

  • Obstetrics & Gynecology Physician
  • Chicago, IL
  • NPI 1316694193
  NPD (past)
• Rehabilitation Associates Inc

  • Pediatric Physical Therapist
  • Virginia Beach, VA
  • NPI 1205860764

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1528156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1659863702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2869 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606574201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2869 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606574201",
            "telephone_number": "733-665-9947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURSIQUOT",
        "first_name": "ABIGAIL",
        "middle_name": "ANDERSEN",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-05",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.015797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shay Bourgeois
• Elizabeth Bourlas, DPT
• Dennis Bourne
• Thomas E. Bournias, M.D.
• Athina Bouroukas, MD
• Jackie Lynn Bousek, ATR, LCPC
• Ava P Bousher
• Richard W Bousson, DPT
• Joseph Thomas Boutet, PA-C
• Catherine-Audrey Boutin, M.D.

• 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 Oct 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.