Individual provider Active NPI

Mollie McMeen, SLP

  • Speech-Language Pathologist
  • Peoria, IL
National Provider Identifier
1679910079
Registry record updated May 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
2338 W Van Winkle Way
Peoria, IL 61615-7483
Phone
(309) 693-9189
Fax
(309) 693-9946
NPI assigned
May 28, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2013

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 IL Primary

Addresses

Primary practice location

2338 W Van Winkle Way
Peoria, IL 61615-7483

Mailing address

2338 W Van Winkle Way
Peoria, IL 61615-7483
Phone (309) 693-9189

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

NPI Registry JSON

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

{
    "created_epoch": "1369699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369699200000",
    "number": "1679910079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2338 W VAN WINKLE WAY",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616157483",
            "telephone_number": "309-693-9189",
            "fax_number": "309-693-9946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2338 W VAN WINKLE WAY",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616157483",
            "telephone_number": "309-693-9189",
            "fax_number": "309-693-9946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMEEN",
        "first_name": "MOLLIE",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-28",
        "last_updated": "2013-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2013; 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.