Active NPI
Tasneem Chathiwala, CCC-SLP
- Speech-Language Pathologist
- Burr Ridge, IL
National Provider Identifier
1720552565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 146012768
- Practice address
- 6101 S County Line Rd
Burr Ridge, IL 60527-8132 - Phone
- (630) 323-2250
- NPI assigned
- Jan 15, 2019
- Last updated
- Jan 15, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 146012768 | IL | Primary |
Addresses
Primary practice location
6101 S County Line Rd
Burr Ridge, IL 60527-8132
Mailing address
709 79TH St Apt 103
Darien, IL 60561-5167
Phone (630) 664-9786
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 |
|---|---|---|---|
| 146012768 | IL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547510400000",
"number": "1720552565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "709 79TH ST APT 103",
"city": "DARIEN",
"state": "IL",
"postal_code": "605615167",
"telephone_number": "630-664-9786"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6101 S COUNTY LINE RD",
"city": "BURR RIDGE",
"state": "IL",
"postal_code": "605278132",
"telephone_number": "630-323-2250"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHATHIWALA",
"first_name": "TASNEEM",
"name_prefix": "Mrs.",
"credential": "CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-01-15",
"last_updated": "2019-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "146012768",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Burr Ridge, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.