Evergreen Pediatric Therapy LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146.0009085 Issued in IL

Legal business name

EVERGREEN PEDIATRIC THERAPY LLC

Practice address

1803 N California Ave
Chicago, IL 60647-5105

Phone

(217) 549-4507

NPI assigned

Jan 8, 2018

Last updated

Jan 8, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Leah Songer, M.A., CCC-SLPNPI 1942559257

Title

Owner/Speech-Language Pathologist

Phone

(217) 549-4507

Specialties & licenses 3

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Leah Allison Songer, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Chicago, IL
  • NPI 1942559257
  NPD (past) Authorized official

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

{
    "created_epoch": "1515369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515369600000",
    "number": "1659888931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 W EVERGREEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1803 N CALIFORNIA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606475105",
            "telephone_number": "217-549-4507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN PEDIATRIC THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-08",
        "last_updated": "2018-01-08",
        "status": "A",
        "authorized_official_last_name": "SONGER",
        "authorized_official_first_name": "LEAH",
        "authorized_official_title_or_position": "OWNER/SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "217-549-4507",
        "authorized_official_credential": "M.A., CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.0009085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nedra Everett, LCSW
• Paul D Everett Jr.
• Tyson Everett, CSAC
• Evergreen Bridgeport LLC
• Evergreen Health & Wellness Inc.
• Evergreen Public Adjusters Services LLC (Greater Midwest)
• Evergreen Uptown LLC
• Joshua Michael Everhart, DO
• Meredith K Everhart, LCSW
• Chloe Evering, MD

• 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 Jan 8, 2018; 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.