Active NPI
Scott Pedziwiatr
- Speech-Language Pathologist
- Joliet, IL
National Provider Identifier
1801411384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Practice address
- 750 Essington Rd
Joliet, IL 60435-4912 - Phone
- (815) 220-5632
- NPI assigned
- Jun 10, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | Primary |
Addresses
Primary practice location
750 Essington Rd
Joliet, IL 60435-4912
Mailing address
742 Essington Rd
Joliet, IL 60435-4912
Phone (815) 220-5632
Other practice location 1
683 Sandpiper Dr
New Lenox, IL 60451-8634
Phone (815) 341-6587
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Westside Childrens Therapy | Speech-Language Pathologist | Past | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647302400000",
"number": "1801411384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "742 ESSINGTON RD",
"city": "JOLIET",
"state": "IL",
"postal_code": "604354912",
"telephone_number": "815-220-5632"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "750 ESSINGTON RD",
"city": "JOLIET",
"state": "IL",
"postal_code": "604354912",
"telephone_number": "815-220-5632"
}
],
"practiceLocations": [
{
"address_1": "683 Sandpiper Dr",
"address_purpose": "LOCATION",
"city": "New Lenox",
"state": "IL",
"postal_code": "604518634",
"country_code": "US",
"telephone_number": "815-341-6587",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PEDZIWIATR",
"first_name": "SCOTT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-06-10",
"last_updated": "2022-03-15",
"certification_date": "2022-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Joliet, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.