Individual provider Active NPI

Eric J Pace

  • Speech-Language Pathologist
  • Crystal Lake, IL
National Provider Identifier
1841566957
Registry record updated Jan 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146.011445 Issued in IL
Practice address
411 E Congress Pkwy
Suite B
Crystal Lake, IL 60014-6247
Phone
(815) 459-3810
Fax
(815) 356-3550
NPI assigned
Mar 23, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2013

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 146.011445 IL Primary

Addresses

Primary practice location

411 E Congress Pkwy
Suite B
Crystal Lake, IL 60014-6247

Mailing address

411 E Congress Pkwy
Suite B
Crystal Lake, IL 60014-6247
Phone (815) 459-3810

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230828001757 IL Practitioner - Qualified Speech Language Pathologist 2163885997 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
146.011445ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Therapeutics LTD Speech-Language Pathologist CurrentSince Jul 14, 2023 Accepting new patients
Comprehensive Therapeutics LTD Speech-Language Pathologist CurrentSince Jul 14, 2023 Accepting new patients
Milestones Therapy Center P.C. Past Accepting new patients

Locations

1015 Oconor Ave
La Salle, IL 61301
Phone (224) 616-5446

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": "1332460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357084800000",
    "number": "1841566957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 E CONGRESS PKWY",
            "address_2": "SUITE B",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600146247",
            "telephone_number": "815-459-3810",
            "fax_number": "815-356-3550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 E CONGRESS PKWY",
            "address_2": "SUITE B",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600146247",
            "telephone_number": "815-459-3810",
            "fax_number": "815-356-3550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACE",
        "first_name": "ERIC",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-23",
        "last_updated": "2013-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.011445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.