Individual provider Active NPI

Anna Cannone

  • Speech-Language Pathologist
  • Batavia, IL
National Provider Identifier
1740768902
Registry record updated Nov 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146015043 Issued in IL
Practice address
1501 S Raddant Rd
Batavia, IL 60510
Phone
(815) 765-2113
NPI assigned
Jul 31, 2018
Last updated
Nov 2, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 146015043 IL Primary

Addresses

Primary practice location

1501 S Raddant Rd
Batavia, IL 60510

Mailing address

335 W Wilson St
Batavia, IL 60510-1948

Other names 1

  • Anna Mitchell Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210909001503 IL Practitioner - Qualified Speech Language Pathologist 6709282130 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
146015043ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Illinois University Current Accepting new patients
Northern Illinois University Speech-Language Pathologist CurrentSince Aug 16, 2021 Accepting new patients
Northern Illinois University Past Accepting new patients

Locations

3100 Sycamore Rd
DeKalb, IL 60115
Phone (815) 752-2675

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1532995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572652800000",
    "number": "1740768902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 W WILSON ST",
            "city": "BATAVIA",
            "state": "IL",
            "postal_code": "605101948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 S RADDANT RD",
            "city": "BATAVIA",
            "state": "IL",
            "postal_code": "60510",
            "telephone_number": "815-765-2113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNONE",
        "first_name": "ANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-31",
        "last_updated": "2019-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146015043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNA",
            "last_name": "MITCHELL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Batavia, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.