Active NPI
Kristin Marie Deblieck, M.S.,CCC-SLP
- Speech-Language Pathologist
- East Moline, IL
National Provider Identifier
1881847093
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 146009623
- Practice address
- 4343 Kennedy Dr
East Moline, IL 61244-4203 - Phone
- (309) 796-6600
- NPI assigned
- Oct 31, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 146009623 | IL | Primary |
Addresses
Primary practice location
4343 Kennedy Dr
East Moline, IL 61244-4203
Mailing address
4343 Kennedy Dr
East Moline, IL 61244-4203
Phone (309) 796-6600
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
| License | State | Type | Specialty |
|---|---|---|---|
| 146009623 | IL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433376000000",
"number": "1881847093",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4343 KENNEDY DR",
"city": "EAST MOLINE",
"state": "IL",
"postal_code": "612444203",
"telephone_number": "309-796-6600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4343 KENNEDY DR",
"city": "EAST MOLINE",
"state": "IL",
"postal_code": "612444203",
"telephone_number": "309-796-6600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEBLIECK",
"first_name": "KRISTIN",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "M.S.,CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-10-31",
"last_updated": "2015-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "146009623",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Moline, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.