Individual provider Active NPI

Elizabeth Ann Rose

  • Speech-Language Pathologist
  • Downers Grove, IL
National Provider Identifier
1679768485
Registry record updated Jul 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
2901 Finley Rd Ste 101
Downers Grove, IL 60515-1394
Phone
(630) 919-8218
NPI assigned
Sep 14, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X IL Primary
Specialist 174400000X 146008823 IL

Addresses

Primary practice location

2901 Finley Rd Ste 101
Downers Grove, IL 60515-1394

Mailing address

2901 Finley Rd Ste 101
Downers Grove, IL 60515-1394
Phone (630) 919-8218

Other practice location 1

310 E. Division St.
Lemont, IL 60439
Phone (773) 322-8073

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
146008823ILMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1189728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656633600000",
    "number": "1679768485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 FINLEY RD STE 101",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151394",
            "telephone_number": "630-919-8218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 FINLEY RD STE 101",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151394",
            "telephone_number": "630-919-8218"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "310 E. Division St.",
            "address_purpose": "LOCATION",
            "city": "Lemont",
            "state": "IL",
            "postal_code": "60439",
            "country_code": "US",
            "telephone_number": "773-322-8073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSE",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-14",
        "last_updated": "2022-07-01",
        "certification_date": "2022-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "146008823",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2022; 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.