Beth Ann Eysenbach, MHS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

6257 N Lakewood Ave
Apt #2
Chicago, IL 60660-1956

Phone

(773) 338-6281

NPI assigned

Apr 3, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689795908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6257 N LAKEWOOD AVE",
            "address_2": "APT #2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606601956",
            "telephone_number": "773-338-6281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6257 N LAKEWOOD AVE",
            "address_2": "APT #2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606601956",
            "telephone_number": "773-338-6281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EYSENBACH",
        "first_name": "BETH",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "MHS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.