Individual provider Active NPI

Laura Boulamatsis

  • Speech-Language Pathologist
  • Des Plaines, IL
National Provider Identifier
1861942260
Registry record updated Oct 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146.004996 Issued in IL
Practice address
886 Webster LN
Des Plaines, IL 60016-6341
Phone
(847) 391-0933
NPI assigned
Oct 10, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2016

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 146.004996 IL Primary

Addresses

Primary practice location

886 Webster LN
Des Plaines, IL 60016-6341

Mailing address

886 Webster LN
Des Plaines, IL 60016-6341
Phone (847) 391-0933

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
146.004996ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1476057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476057600000",
    "number": "1861942260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "886 WEBSTER LN",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600166341",
            "telephone_number": "847-391-0933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "886 WEBSTER LN",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600166341",
            "telephone_number": "847-391-0933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULAMATSIS",
        "first_name": "LAURA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-10",
        "last_updated": "2016-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.004996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Plaines, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2016; 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.