Individual provider Active NPI

Jan Prazak, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Downers Grove, IL
National Provider Identifier
1720319031
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146.000022 Issued in IL
Practice address
3815 Highland Ave
Downers Grove, IL 60515-1500
Phone
(630) 275-1110
NPI assigned
Jan 26, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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 146.000022 IL Primary

Addresses

Primary practice location

3815 Highland Ave
Downers Grove, IL 60515-1500

Mailing address

3815 Highland Ave
Downers Grove, IL 60515-1500
Phone (630) 275-1110

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)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
146.000022ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1264464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1720319031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3815 HIGHLAND AVE",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151500",
            "telephone_number": "630-275-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3815 HIGHLAND AVE",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151500",
            "telephone_number": "630-275-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRAZAK",
        "first_name": "JAN",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-26",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.000022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2024; 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.