Individual provider Active NPI

Christine Wancket, SLP

  • Speech-Language Pathologist
  • Chicago, IL
National Provider Identifier
1790169589
Registry record updated Mar 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146011622 Issued in IL
Practice address
9813 S Hoyne Ave
Chicago, IL 60643-1728
Phone
(708) 305-0733
NPI assigned
Jul 12, 2015
Last updated
Mar 5, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X NU
Speech-Language Pathologist 235Z00000X 146011622 IL Primary

Addresses

Primary practice location

9813 S Hoyne Ave
Chicago, IL 60643-1728

Mailing address

9813 S Hoyne Ave
Chicago, IL 60643-1728
Phone (708) 305-0733

Other practice location 1

345 E Superior St
Chicago, IL 60611-2654
Phone (312) 238-1000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210830002876 IL Practitioner - Qualified Speech Language Pathologist 9133525124 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Neuro Speech Connections PLLC Speech-Language Pathologist CurrentSince Jul 23, 2021 Accepting new patients

Organizations & group practices 1

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": "1436659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551744000000",
    "number": "1790169589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9813 S HOYNE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606431728",
            "telephone_number": "708-305-0733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9813 S HOYNE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606431728",
            "telephone_number": "708-305-0733"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "345 E Superior St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606112654",
            "country_code": "US",
            "telephone_number": "312-238-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANCKET",
        "first_name": "CHRISTINE",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-12",
        "last_updated": "2019-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146011622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 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.