Active NPI
Kimberly Marie Wolf, M.A. CCC-SLP/L
- Speech-Language Pathologist
- Lombard, IL
National Provider Identifier
1730729286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 146006141
- Practice address
- 1519 S Grace St
Lombard, IL 60148-4649 - Phone
- (630) 827-4036
- NPI assigned
- Jan 13, 2020
- 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 | 146006141 | IL | Primary |
Addresses
Primary practice location
1519 S Grace St
Lombard, IL 60148-4649
Mailing address
526 Cardinal Ave
Oswego, IL 60543-7745
Phone (630) 862-0857
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146006141 | IL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1578873600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578873600000",
"number": "1730729286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "526 CARDINAL AVE",
"city": "OSWEGO",
"state": "IL",
"postal_code": "605437745",
"telephone_number": "630-862-0857"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1519 S GRACE ST",
"city": "LOMBARD",
"state": "IL",
"postal_code": "601484649",
"telephone_number": "630-827-4036"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLF",
"first_name": "KIMBERLY",
"middle_name": "MARIE",
"credential": "M.A. CCC-SLP/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-01-13",
"last_updated": "2020-01-13",
"certification_date": "2020-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "146006141",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lombard, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.