Gwen Sabo, M.S.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

242.004697 Issued in IL

Practice address

108 W Church St
Collinsville, IL 62234-2725

Phone

(618) 346-6301

NPI assigned

Nov 17, 2017

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 17, 2017.

{
    "created_epoch": "1510876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510876800000",
    "number": "1871007591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 W CHURCH ST",
            "city": "COLLINSVILLE",
            "state": "IL",
            "postal_code": "622342725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 W CHURCH ST",
            "city": "COLLINSVILLE",
            "state": "IL",
            "postal_code": "622342725",
            "telephone_number": "618-346-6301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SABO",
        "first_name": "GWEN",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-17",
        "last_updated": "2017-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "242.004697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Collinsville, IL
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2017; 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.