Individual provider Active NPI

Deborah Davis, SLP

  • Speech-Language Pathologist
  • Libertyville, IL
National Provider Identifier
1801126628
Registry record updated Dec 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146.005597 Issued in IL
Practice address
1870 W Winchester Rd
Suite 203
Libertyville, IL 60048-5358
Phone
(847) 816-7200
NPI assigned
Dec 29, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2009

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 146.005597 IL Primary

Addresses

Primary practice location

1870 W Winchester Rd
Suite 203
Libertyville, IL 60048-5358

Mailing address

PO Box 7365
Libertyville, IL 60048
Phone (847) 816-7200

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
146.005597ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1262044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262044800000",
    "number": "1801126628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7365",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "60048",
            "telephone_number": "847-816-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1870 W WINCHESTER RD",
            "address_2": "SUITE 203",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485358",
            "telephone_number": "847-816-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "DEBORAH",
        "name_prefix": "Mrs.",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-29",
        "last_updated": "2009-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.005597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2009; 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.