Individual provider Active NPI

Patricia Lynn Roe, M.H.S., CCC, SLP/L

  • Speech-Language Pathologist
  • Calumet City, IL
National Provider Identifier
1669616140
Registry record updated Jul 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146-006395 Issued in IL
Practice address
39 Sycamore CT
Calumet City, IL 60409-5017
Phone
(773) 485-8336
NPI assigned
Apr 28, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2019

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 146-006395 IL Primary

Addresses

Primary practice location

39 Sycamore CT
Calumet City, IL 60409-5017

Mailing address

39 Sycamore CT
Calumet City, IL 60409-5017
Phone (773) 485-8336

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
146-006395ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1240876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564358400000",
    "number": "1669616140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 SYCAMORE CT",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "604095017",
            "telephone_number": "773-485-8336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 SYCAMORE CT",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "604095017",
            "telephone_number": "773-485-8336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROE",
        "first_name": "PATRICIA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "M.H.S., CCC, SLP/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-28",
        "last_updated": "2019-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146-006395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Calumet City, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2019; 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.