Individual provider Active NPI

Christy Lynn Brosseau, MHS CCC/SLP

  • Speech-Language Pathologist
  • Downers Grove, IL
National Provider Identifier
1851647093
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146005013 Issued in IL
Practice address
2901 Finley Rd Ste 102
Downers Grove, IL 60515-1774
Phone
(630) 495-6800
Fax
(630) 495-8200
NPI assigned
Jul 25, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 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 146005013 IL Primary

Addresses

Primary practice location

2901 Finley Rd Ste 102
Downers Grove, IL 60515-1774

Mailing address

2901 Finley Rd Ste 102
Downers Grove, IL 60515-1774
Phone (630) 495-6800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210527001892 IL Practitioner - Qualified Speech Language Pathologist 8224437025 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
146005013ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Spot It All Therapy Inc Speech-Language Pathologist CurrentSince May 17, 2021 Accepting new patients
Spot It All Therapy Inc Speech-Language Pathologist CurrentSince May 17, 2021 Accepting new patients
Therapeutic Strategies, Inc Speech-Language Pathologist PastSince Nov 29, 2020 Accepting new patients

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": "1343174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1851647093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 FINLEY RD STE 102",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151774",
            "telephone_number": "630-495-6800",
            "fax_number": "630-495-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 FINLEY RD STE 102",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151774",
            "telephone_number": "630-495-6800",
            "fax_number": "630-495-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROSSEAU",
        "first_name": "CHRISTY",
        "middle_name": "LYNN",
        "credential": "MHS CCC/SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-25",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146005013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2020; 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.