Active NPI
Traci A Micek, MA SLP CCC
- Speech-Language Pathologist
- Vernon Hills, IL
National Provider Identifier
1689952822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 146007078
- Practice address
- 200 N Fairway Dr Ste 208
Vernon Hills, IL 60061-1803 - Phone
- (847) 996-6666
- Fax
- (847) 996-6665
- NPI assigned
- Jul 21, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 146007078 | IL | Primary |
Addresses
Primary practice location
200 N Fairway Dr Ste 208
Vernon Hills, IL 60061-1803
Mailing address
200 N Fairway Dr Ste 208
Vernon Hills, IL 60061-1803
Phone (847) 996-6666
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146007078 | IL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311206400000",
"number": "1689952822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 N FAIRWAY DR STE 208",
"city": "VERNON HILLS",
"state": "IL",
"postal_code": "600611803",
"telephone_number": "847-996-6666",
"fax_number": "847-996-6665"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 N FAIRWAY DR STE 208",
"city": "VERNON HILLS",
"state": "IL",
"postal_code": "600611803",
"telephone_number": "847-996-6666",
"fax_number": "847-996-6665"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICEK",
"first_name": "TRACI",
"middle_name": "A",
"credential": "MA SLP CCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-07-21",
"last_updated": "2011-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "146007078",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vernon Hills, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.