Individual provider Active NPI

Josephine Sampson, CCC SLP/L

  • Speech-Language Pathologist
  • Burr Ridge, IL
National Provider Identifier
1801120985
Registry record updated Sep 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146009495 Issued in IL
Practice address
16W361 S Frontage Rd
Suite 131
Burr Ridge, IL 60527-5830
Phone
(630) 590-5571
NPI assigned
Sep 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2013

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 146009495 IL Primary

Addresses

Primary practice location

16W361 S Frontage Rd
Suite 131
Burr Ridge, IL 60527-5830

Mailing address

16W361 S Frontage Rd
Suite 131
Burr Ridge, IL 60527-5830
Phone (630) 590-5571

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
146009495ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1253664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378339200000",
    "number": "1801120985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16W361 S FRONTAGE RD",
            "address_2": "SUITE 131",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605275830",
            "telephone_number": "630-590-5571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16W361 S FRONTAGE RD",
            "address_2": "SUITE 131",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605275830",
            "telephone_number": "630-590-5571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMPSON",
        "first_name": "JOSEPHINE",
        "credential": "CCC SLP/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-23",
        "last_updated": "2013-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146009495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burr Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2013; 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.