Individual provider Active NPI

Cathy Ann Muckian

  • Speech-Language Pathologist
  • New Lenox, IL
National Provider Identifier
1861871592
Registry record updated May 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1831290 Issued in IL
Practice address
1622 Andrea Dr
New Lenox, IL 60451-2304
Phone
(815) 790-3217
NPI assigned
May 27, 2015
Last updated
May 27, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2015

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 1831290 IL Primary

Addresses

Primary practice location

1622 Andrea Dr
New Lenox, IL 60451-2304

Mailing address

1622 Andrea Dr
New Lenox, IL 60451-2304
Phone (815) 790-3217

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
1831290ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1432684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432684800000",
    "number": "1861871592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1622 ANDREA DR",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604512304",
            "telephone_number": "815-790-3217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1622 ANDREA DR",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604512304",
            "telephone_number": "815-790-3217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUCKIAN",
        "first_name": "CATHY ANN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-27",
        "last_updated": "2015-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "1831290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Lenox, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2015; 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.