Nadine Broz Heraty, M.A.CCC-SLP/L

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146.003745 Issued in IL

Practice address

226 State St
St Charles, IL 60174-1864

Phone

(630) 587-3777

NPI assigned

Oct 20, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Nadine Mari Broz Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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  NPD (past)
• Riverview Counseling Services, LTD.

  • Mental Health Counselor
  • St Charles, IL
  • NPI 1912078262

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1287532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287532800000",
    "number": "1730499013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1763 FLAGSTONE LN",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605028651",
            "telephone_number": "630-898-0755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 STATE ST",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601741864",
            "telephone_number": "630-587-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERATY",
        "first_name": "NADINE",
        "middle_name": "BROZ",
        "name_prefix": "Mrs.",
        "credential": "M.A.CCC-SLP/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-20",
        "last_updated": "2010-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.003745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NADINE",
            "last_name": "BROZ",
            "middle_name": "MARI",
            "prefix": "MISS",
            "credential": "M.A.CCC-SLP/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rona Lee Henne, OTR/L
• Abigail Henry, LPC
• Maureen Patricia Henry, LCSW
• Maureen T Henry
• Christina M Hensel, MOT, OTR/L
• Elizabeth W Heredia
• Heritage Path Counseling PLLC
• Herman P Langner MD, LTD.
• Maylea Herrera
• Laura Herrmann, RD, LDN, CD

• Speech-Language Pathologist in St Charles, IL
• Providers in St Charles, IL by specialty
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2010; 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.