Individual provider Active NPI

Mary Stanton

  • Speech-Language Pathologist
  • Chicago, IL
National Provider Identifier
1790198315
Registry record updated Jan 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
242.003007 Issued in IL
Practice address
4958 N Milwaukee Ave
Chicago, IL 60630-2377
Phone
(773) 205-8505
NPI assigned
Jun 11, 2014
Last updated
Jan 27, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2017

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 242.003007 IL Primary

Addresses

Primary practice location

4958 N Milwaukee Ave
Chicago, IL 60630-2377

Mailing address

4958 N Milwaukee Ave
Chicago, IL 60630-2377
Phone (773) 205-8505

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

State licenses

LicenseStateTypeSpecialty
242.003007ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1402444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485475200000",
    "number": "1790198315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4958 N MILWAUKEE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606302377",
            "telephone_number": "773-205-8505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4958 N MILWAUKEE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606302377",
            "telephone_number": "773-205-8505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANTON",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-11",
        "last_updated": "2017-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "242.003007",
            "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 Jan 27, 2017; 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.