Individual provider Active NPI

Cristina Chung

  • Speech-Language Pathologist
  • Wilmette, IL
National Provider Identifier
1811403645
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146.006877 Issued in IL
Practice address
615 Locust Rd
Wilmette, IL 60091-2237
Phone
(847) 512-6000
NPI assigned
Dec 15, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 146.006877 IL Primary

Addresses

Primary practice location

615 Locust Rd
Wilmette, IL 60091-2237

Mailing address

569 Hunter Rd
Wilmette, IL 60091-2209
Phone (847) 512-6523

Other practice location 1

649 Prairie Ave
Wilmette, IL 60091-2531
Phone (847) 512-6300

Other practice location 2

1101 Dartmouth St
Wilmette, IL 60091-1362
Phone (847) 512-6200

Other practice location 3

910 Central Ave
Wilmette, IL 60091-2608
Phone (847) 512-6100

Other practice location 4

620 Locust Rd
Wilmette, IL 60091-2200
Phone (847) 512-6600

Other practice location 5

600 Romona Rd
Wilmette, IL 60091-2125
Phone (847) 512-6400

Other practice location 6

569 Hunter Rd
Wilmette, IL 60091-2209
Phone (847) 512-6500

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
146.006877ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1513296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1811403645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "569 HUNTER RD",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600912209",
            "telephone_number": "847-512-6523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 LOCUST RD",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600912237",
            "telephone_number": "847-512-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "649 Prairie Ave",
            "address_purpose": "LOCATION",
            "city": "Wilmette",
            "state": "IL",
            "postal_code": "600912531",
            "country_code": "US",
            "telephone_number": "847-512-6300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1101 Dartmouth St",
            "address_purpose": "LOCATION",
            "city": "Wilmette",
            "state": "IL",
            "postal_code": "600911362",
            "country_code": "US",
            "telephone_number": "847-512-6200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "910 Central Ave",
            "address_purpose": "LOCATION",
            "city": "Wilmette",
            "state": "IL",
            "postal_code": "600912608",
            "country_code": "US",
            "telephone_number": "847-512-6100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "620 Locust Rd",
            "address_purpose": "LOCATION",
            "city": "Wilmette",
            "state": "IL",
            "postal_code": "600912200",
            "country_code": "US",
            "telephone_number": "847-512-6600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 Romona Rd",
            "address_purpose": "LOCATION",
            "city": "Wilmette",
            "state": "IL",
            "postal_code": "600912125",
            "country_code": "US",
            "telephone_number": "847-512-6400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "569 Hunter Rd",
            "address_purpose": "LOCATION",
            "city": "Wilmette",
            "state": "IL",
            "postal_code": "600912209",
            "country_code": "US",
            "telephone_number": "847-512-6500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "CRISTINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-15",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.006877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmette, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.