Individual provider Active NPI

Laura Sofen

  • Speech-Language Pathologist
  • Chicago, IL
National Provider Identifier
1700335320
Registry record updated Dec 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
5399 Issued in WI
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

Updated by the provider on Dec 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
242004232OtherILSPEECH-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

LicenseStateTypeSpecialty
242004232ILMDSpeech-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.

Verify at the official NPI Registry.