Individual provider Active NPI

Melissa Lynn Wise, MS SLP

  • Speech-Language Pathologist
  • Lake Zurich, IL
National Provider Identifier
1881629319
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
122 W Harbor Dr
Lake Zurich, IL 60047
Phone
(847) 302-0833
Fax
(847) 438-9141
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 IL Primary

Addresses

Primary practice location

122 W Harbor Dr
Lake Zurich, IL 60047

Mailing address

122 W Harbor Dr
Lake Zurich, IL 60047
Phone (847) 302-0833

Other identifiers 2

IdentifierTypeStateIssuer
5632106OtherILBLUECROSS BLUESHIELD
9387565OtherILPRIVATE HEALTH CARE SYSTE

Other names 1

  • Melissa Lynn Sonka Former name

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
146007601ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Wise Speech Connections PLLC Speech-Language Pathologist Current Accepting new patients

Organizations & group practices 1

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881629319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 W HARBOR DR",
            "city": "LAKE ZURICH",
            "state": "IL",
            "postal_code": "60047",
            "telephone_number": "847-302-0833",
            "fax_number": "847-438-9141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 W HARBOR DR",
            "city": "LAKE ZURICH",
            "state": "IL",
            "postal_code": "60047",
            "telephone_number": "847-302-0833",
            "fax_number": "847-438-9141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "MELISSA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "MS SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "5632106",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE HEALTH CARE SYSTE",
            "identifier": "9387565",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "SONKA",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lake Zurich, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.