Individual provider Active NPI

Ellen Marie Ledesma, MHS

  • Speech-Language Pathologist
  • Oswego, IL
National Provider Identifier
1750446142
Registry record updated Feb 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146.010079 Issued in IL
Practice address
470 Grape Vine TRL
Suite 100
Oswego, IL 60543-6017
Phone
(630) 661-7253
Fax
(855) 765-7549
NPI assigned
Dec 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2015

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 146.010079 IL Primary

Addresses

Primary practice location

470 Grape Vine TRL
Suite 100
Oswego, IL 60543-6017

Mailing address

470 Grape Vine TRL
Oswego, IL 60543-6017
Phone (630) 661-7253

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160217001170 IL Practitioner - Qualified Speech Language Pathologist 2264737956 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

975 N 5TH Ave
St Charles, IL 60174-1299
Phone (630) 797-5115

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
146.010079ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Services Il LLC Speech-Language Pathologist CurrentSince Sep 1, 2021 Accepting new patients
Legacy Healthcare Services Inc Speech-Language Pathologist CurrentSince Feb 2, 2026 Accepting new patients
Legacy Healthcare Services Inc Speech-Language Pathologist CurrentSince Feb 2, 2026 Accepting new patients
Positive Outcomes Inc. Speech-Language Pathologist PastSince Jan 26, 2025 Accepting new patients

Locations

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300

7 Carnegie Plz
Cherry Hill, NJ 08003

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422921600000",
    "number": "1750446142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "470 GRAPE VINE TRL",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "605436017",
            "telephone_number": "630-661-7253",
            "fax_number": "855-765-7549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 GRAPE VINE TRL",
            "address_2": "SUITE 100",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "605436017",
            "telephone_number": "630-661-7253",
            "fax_number": "855-765-7549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDESMA",
        "first_name": "ELLEN",
        "middle_name": "MARIE",
        "credential": "MHS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-26",
        "last_updated": "2015-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.010079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oswego, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.