Speakology, LTD

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146007832 Issued in IL

Legal business name

SPEAKOLOGY, LTD

Practice address

29862 White Oak Dr
Mackinaw, IL 61755-8979

Phone

(309) 648-1217

Fax

(309) 359-3234

NPI assigned

Jul 24, 2015

Last updated

Sep 2, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nicole L Campbell

Title

Speech Language Pathologist

Phone

(309) 648-1217

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1437696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441152000000",
    "number": "1730564212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29862 WHITE OAK DR",
            "city": "MACKINAW",
            "state": "IL",
            "postal_code": "617558979",
            "telephone_number": "309-648-1217",
            "fax_number": "309-359-3234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29862 WHITE OAK DR",
            "city": "MACKINAW",
            "state": "IL",
            "postal_code": "617558979",
            "telephone_number": "309-648-1217",
            "fax_number": "309-359-3234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPEAKOLOGY, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-24",
        "last_updated": "2015-09-02",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SPEECH LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "309-648-1217"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146007832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "348724545001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Mackinaw, IL
• Providers in Mackinaw, 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 Sep 2, 2015; 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.