Individual provider Active NPI

Mary-Kelsey Coletto

  • Speech-Language Pathologist
  • Highland Park, IL
National Provider Identifier
1902217391
Registry record updated Sep 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146.010428 Issued in IL
Practice address
760 Red Oak LN
Highland Park, IL 60035-3816
Phone
(847) 831-5100
NPI assigned
May 19, 2014
Last updated
Sep 10, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2018

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 146.010428 IL Primary

Addresses

Primary practice location

760 Red Oak LN
Highland Park, IL 60035-3816

Mailing address

760 Red Oak LN
Highland Park, IL 60035-3816
Phone (847) 831-5100

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
146.010428ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Suburban Special Education District Past Accepting new patients
Northern Suburban Special Education District Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1400457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536537600000",
    "number": "1902217391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 RED OAK LN",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600353816",
            "telephone_number": "847-831-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 RED OAK LN",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600353816",
            "telephone_number": "847-831-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLETTO",
        "first_name": "MARY-KELSEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-19",
        "last_updated": "2018-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.010428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2018; 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.