Individual provider Active NPI

Julie Brzezinski X, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Mequon, WI
National Provider Identifier
1760555247
Registry record updated Aug 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146.010403 Issued in IL
Practice address
13111 N Port Washington Rd
Smo-Outpt Rehab Dept, Speech TX
Mequon, WI 53097-2416
Phone
(262) 243-7444
NPI assigned
Nov 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2012

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 146.010403 IL Primary

Addresses

Primary practice location

13111 N Port Washington Rd
Smo-Outpt Rehab Dept, Speech TX
Mequon, WI 53097-2416

Mailing address

1401 S California Ave
Schwab Rehab Hospital, Inpatient Therapy
Chicago, IL 60608-1858

Other identifiers 1

IdentifierTypeStateIssuer
42581000MedicaidWI

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 Science

State licenses

LicenseStateTypeSpecialty
146.010403ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346025600000",
    "number": "1760555247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 S CALIFORNIA AVE",
            "address_2": "SCHWAB REHAB HOSPITAL, INPATIENT THERAPY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13111 N PORT WASHINGTON RD",
            "address_2": "SMO-OUTPT REHAB DEPT, SPEECH TX",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530972416",
            "telephone_number": "262-243-7444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRZEZINSKI",
        "first_name": "JULIE",
        "name_suffix": "X",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2012-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.010403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42581000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mequon, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2012; 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.