Individual provider Active NPI

Kristine Kay Pardikes, CCC-SLP/L

  • Speech-Language Pathologist
  • Palos Park, IL
National Provider Identifier
1679893879
Registry record updated Jun 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146.008294 Issued in IL
Practice address
12811 S 82ND CT
Palos Park, IL 60464-2020
Phone
(708) 448-2424
NPI assigned
Jun 10, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2010

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 146.008294 IL Primary

Addresses

Primary practice location

12811 S 82ND CT
Palos Park, IL 60464-2020

Mailing address

12811 S 82ND CT
Palos Park, IL 60464-2020
Phone (708) 448-2424

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
146.008294ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1276128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276128000000",
    "number": "1679893879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12811 S 82ND CT",
            "city": "PALOS PARK",
            "state": "IL",
            "postal_code": "604642020",
            "telephone_number": "708-448-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12811 S 82ND CT",
            "city": "PALOS PARK",
            "state": "IL",
            "postal_code": "604642020",
            "telephone_number": "708-448-2424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARDIKES",
        "first_name": "KRISTINE",
        "middle_name": "KAY",
        "credential": "CCC-SLP/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-10",
        "last_updated": "2010-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.008294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2010; 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.