Individual provider Active NPI

Maureen Dickman, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Rantoul, IL
National Provider Identifier
1710606793
Registry record updated Aug 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146016438 Issued in IL
Practice address
1625 Short St
Rantoul, IL 61866-3335
Phone
(217) 893-4141
NPI assigned
Aug 24, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 146016438 IL Primary

Addresses

Primary practice location

1625 Short St
Rantoul, IL 61866-3335

Mailing address

1625 Short St
Rantoul, IL 61866-3335
Phone (217) 893-4141

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 Science

State licenses

LicenseStateTypeSpecialty
146016438ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1661299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1710606793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 SHORT ST",
            "city": "RANTOUL",
            "state": "IL",
            "postal_code": "618663335",
            "telephone_number": "217-893-4141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 SHORT ST",
            "city": "RANTOUL",
            "state": "IL",
            "postal_code": "618663335",
            "telephone_number": "217-893-4141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKMAN",
        "first_name": "MAUREEN",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-24",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146016438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rantoul, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; 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.