Active NPI
Sharron A. Ridgenal
- Speech-Language Assistant
- Tinley Park, IL
National Provider Identifier
1730526047
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- 217.000062
- Practice address
- 18103 66TH CT
Tinley Park, IL 60477-4106 - Phone
- (708) 429-7336
- NPI assigned
- May 28, 2013
- 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 Assistant | 2355S0801X | 217.000062 | IL | Primary |
Addresses
Primary practice location
18103 66TH CT
Tinley Park, IL 60477-4106
Mailing address
18103 S. 66TH Court
Tinley Park, IL 60477-4106
Phone (708) 429-7336
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 |
|---|---|---|---|
| 217.000062 | IL | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572825600000",
"number": "1730526047",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18103 S. 66TH COURT",
"city": "TINLEY PARK",
"state": "IL",
"postal_code": "604774106",
"telephone_number": "708-429-7336"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18103 66TH CT",
"city": "TINLEY PARK",
"state": "IL",
"postal_code": "604774106",
"telephone_number": "708-429-7336"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIDGENAL",
"first_name": "SHARRON",
"middle_name": "A.",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-05-28",
"last_updated": "2019-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "IL",
"license": "217.000062",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tinley Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.