Reilly Bootle, M.S. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146.014681 Issued in IL

Practice address

10300 Southwest Hwy
Chicago Ridge, IL 60415-1426

Phone

(708) 425-1100

NPI assigned

Nov 10, 2020

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 10, 2020.

{
    "created_epoch": "1604966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1821690397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 SOUTH BLVD APT 913",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603024281",
            "telephone_number": "716-361-7727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10300 SOUTHWEST HWY",
            "city": "CHICAGO RIDGE",
            "state": "IL",
            "postal_code": "604151426",
            "telephone_number": "708-425-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTLE",
        "first_name": "REILLY",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-10",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.014681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Bandemer, OD
• Robin Louise Bauman, SLPP
• Gina Berg
• Aaron D Berger, M.D.
• Paul Robert Boone
• Christine D Boyd, M.D.
• Kristin Bragiel
• Karen M Brann, APN
• Aidan Martin Brodie, COTA
• Kristen Bugajski

• All providers in Chicago Ridge, IL
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2020; 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.