Individual provider Active NPI

Nancy A. Mattes, M.A.CCC/SLP

  • Speech-Language Pathologist
  • Palos Park, IL
National Provider Identifier
1891951000
Registry record updated Aug 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146.003009 Issued in IL
Practice address
13045 S 83Rd CT
Palos Park, IL 60464-2144
Phone
(708) 361-3984
NPI assigned
Aug 6, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2008

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 146.003009 IL Primary

Addresses

Primary practice location

13045 S 83Rd CT
Palos Park, IL 60464-2144

Mailing address

13045 S 83Rd CT
Palos Park, IL 60464-2144
Phone (708) 361-3984

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
146.003009ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1217980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217980800000",
    "number": "1891951000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13045 S 83RD CT",
            "city": "PALOS PARK",
            "state": "IL",
            "postal_code": "604642144",
            "telephone_number": "708-361-3984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13045 S 83RD CT",
            "city": "PALOS PARK",
            "state": "IL",
            "postal_code": "604642144",
            "telephone_number": "708-361-3984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTES",
        "first_name": "NANCY",
        "middle_name": "A.",
        "name_prefix": "Mrs.",
        "credential": "M.A.CCC/SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-06",
        "last_updated": "2008-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.003009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2008; 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.