Individual provider Active NPI

Mary O'Grady

  • Speech-Language Pathologist
  • Gurnee, IL
National Provider Identifier
1699901207
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146.008638 Issued in IL
Practice address
7000 Washington St
Gurnee, IL 60031-5309
Phone
(847) 856-3403
NPI assigned
Jun 9, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 146.008638 IL Primary

Addresses

Primary practice location

7000 Washington St
Gurnee, IL 60031-5309

Mailing address

1125 Trevor Cir
Libertyville, IL 60048-4419

Other practice location 1

3703 W Lake Ave
Suite 200
Glenview, IL 60026-5823
Phone (847) 998-1188

Other names 1

  • Mary Kienzler Former name

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
146.008638ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1244505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1699901207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 TREVOR CIR",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600484419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 WASHINGTON ST",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600315309",
            "telephone_number": "847-856-3403"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3703 W Lake Ave",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Glenview",
            "state": "IL",
            "postal_code": "600265823",
            "country_code": "US",
            "telephone_number": "847-998-1188",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'GRADY",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-09",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.008638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "KIENZLER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gurnee, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.