Anna Cannone
Individual provider Active NPI Speech-Language Pathologist · Batavia, IL
NPI 1740768902 · NPPES record last updated Nov 2, 2019
Key facts
- NPI
- 1740768902
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 146015043 (IL)
- Practice address
- 1501 S Raddant Rd
Batavia, IL 60510 - Phone
- (815) 765-2113
- NPI assigned
- Jul 31, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210909001503 | IL | Practitioner - Qualified Speech Language Pathologist | 6709282130 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146015043 | IL | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northern Illinois University | Speech-Language Pathologist | Current |
Accepting new patients |
| Northern Illinois University | Current | Accepting new patients | |
| Northern Illinois University | Past | Accepting new patients |
Locations
3100 Sycamore Rd
DeKalb, IL 60115
Phone (815) 752-2675
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 146015043 | IL | Yes |
Addresses
Primary practice location
1501 S Raddant Rd
Batavia, IL 60510
Mailing address
335 W Wilson St
Batavia, IL 60510-1948
Other names
- Anna Mitchell
Other providers in Batavia, IL
- Elizabeth Ann Busteed
- Chloe Christina Caldera
- Mary Rose Calderone
- Amanda Callaci
- Philip Cameron
- Kelly A. Carlson
- Heather Michelle Caron
- Lisa Cassingham
- Marisa Castillo
- Rob J. Castillo
All providers in Batavia, IL · Speech-Language Pathologist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 2, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.