Active NPI
Laura Sofen
- Speech-Language Pathologist
- Chicago, IL
National Provider Identifier
1700335320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 5399
- Practice address
- 3535 N Racine Ave Apt 3
Chicago, IL 60657-1532 - Phone
- (517) 256-2638
- NPI assigned
- Sep 23, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 242004232 | IL | |
| Speech-Language Pathologist | 235Z00000X | 5399 | WI | Primary |
Addresses
Primary practice location
3535 N Racine Ave Apt 3
Chicago, IL 60657-1532
Mailing address
5026 N Idlewild Ave
Whitefish Bay, WI 53217-5631
Phone (517) 256-2638
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 242004232 | Other | IL | SPEECH-LANGUAGE PATHOLOGY TEMPORARY LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 242004232 | IL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1474588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640044800000",
"number": "1700335320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5026 N IDLEWILD AVE",
"city": "WHITEFISH BAY",
"state": "WI",
"postal_code": "532175631",
"telephone_number": "517-256-2638"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3535 N RACINE AVE APT 3",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606571532",
"telephone_number": "517-256-2638"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOFEN",
"first_name": "LAURA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-23",
"last_updated": "2021-12-21",
"certification_date": "2021-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "242004232",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WI",
"license": "5399",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SPEECH-LANGUAGE PATHOLOGY TEMPORARY LICENSE",
"identifier": "242004232",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.