Individual provider Active NPI

Shannon Filipponi

  • Speech-Language Pathologist
  • Chicago, IL
National Provider Identifier
1669768669
Registry record updated Nov 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146.013473 Issued in IL
Practice address
811 W Evergreen Ave
Suite 404
Chicago, IL 60642-2682
Phone
(312) 975-3928
Fax
(888) 972-7531
NPI assigned
Jun 28, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SZ5381 FL
Speech-Language Pathologist 235Z00000X SA11709 FL
Speech-Language Pathologist 235Z00000X 146.013473 IL Primary

Addresses

Primary practice location

811 W Evergreen Ave
Suite 404
Chicago, IL 60642-2682

Mailing address

811 W Evergreen Ave
Suite 404
Chicago, IL 60642-2682
Phone (312) 975-3928

Other identifiers 1

IdentifierTypeStateIssuer
003733300MedicaidFL

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
SA11709FLMDSpeech-Language Pathologist
146.013473ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrity Therapy Solutions, Inc. Speech-Language Pathologist Past Accepting new patients
Beth Ingram & Associates, Inc. Speech-Language Pathologist Past Accepting new patients

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": "1309219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479081600000",
    "number": "1669768669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 W EVERGREEN AVE",
            "address_2": "SUITE 404",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606422682",
            "telephone_number": "312-975-3928",
            "fax_number": "888-972-7531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 W EVERGREEN AVE",
            "address_2": "SUITE 404",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606422682",
            "telephone_number": "312-975-3928",
            "fax_number": "888-972-7531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FILIPPONI",
        "first_name": "SHANNON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-28",
        "last_updated": "2016-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ5381",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA11709",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.013473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003733300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.