Individual provider Active NPI

Gabrielle Klugman, MS CCC-SLP

  • Speech-Language Pathologist
  • Chicago, IL
National Provider Identifier
1821699794
Registry record updated Nov 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146014784 Issued in IL
Practice address
2525 S Michigan Ave
Chicago, IL 60616-2332
Phone
(312) 567-2160
NPI assigned
Nov 5, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2020

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 146014784 IL Primary

Addresses

Primary practice location

2525 S Michigan Ave
Chicago, IL 60616-2332

Mailing address

1529 S State St Apt 10-H
Chicago, IL 60605-3098
Phone (708) 408-6221

Other practice location 1

1500 S Fairfield Ave
Chicago, IL 60608-1782
Phone (773) 542-2000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gabrielle.klugman@mercy-chicago.org Mercy Hospital and Medical Center

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210211000165 IL Practitioner - Qualified Speech Language Pathologist 4880009539 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rci (WRS) LLCGroup PAC ID 5092624510, 325 clinicians

Practice addresses (Care Compare)

1725 W Harrison St
Suite 440
Chicago, IL 60612-3836
Phone (312) 563-2454

826 W Touhy Ave
Park Ridge, IL 60068-3352
Phone (847) 720-4165

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
146014784ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Rci (WRS), LLC. CurrentSince Dec 1, 2020 Accepting new patients
Rci (WRS), LLC. Current Accepting new patients
Rci (WRS), LLC CurrentSince Dec 1, 2020 Accepting new patients

Locations

1725 W Harrison St
Ste 440
Chicago, IL 60612
Phone (312) 563-2454

9000 W College Pkwy
Palos Hills, IL 60465
Phone (618) 529-3201

826 W Touhy Ave
Park Ridge, IL 60068
Phone (847) 720-4165

Organizations & group practices 3

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": "1604534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604534400000",
    "number": "1821699794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1529 S STATE ST APT 10-H",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606053098",
            "telephone_number": "708-408-6221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 S MICHIGAN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162332",
            "telephone_number": "312-567-2160"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 S Fairfield Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606081782",
            "country_code": "US",
            "telephone_number": "773-542-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLUGMAN",
        "first_name": "GABRIELLE",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-05",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146014784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gabrielle.klugman@mercy-chicago.org",
            "affiliation": "Y",
            "endpointDescription": "confidential email",
            "affiliationName": "Mercy Hospital and Medical Center",
            "address_1": "2525 S Michigan Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606162332",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.