Individual provider Active NPI

Mary Kathryn Groenke, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Mount Prospect, IL
National Provider Identifier
1902572837
Registry record updated Apr 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
242006495 Issued in IL
Practice address
701 W Gregory St
Mount Prospect, IL 60056-2220
Phone
(847) 394-7300
NPI assigned
Aug 20, 2021
Last updated
Apr 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2023

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 242006495 IL Primary

Addresses

Primary practice location

701 W Gregory St
Mount Prospect, IL 60056-2220

Mailing address

988 Stonewood Glen Dr
Geneva, IL 60134-3698
Phone (630) 470-7702

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
242006495ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Assential Therapies Inc PastSince Aug 1, 2021 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, 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": "1629417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680393600000",
    "number": "1902572837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "988 STONEWOOD GLEN DR",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601343698",
            "telephone_number": "630-470-7702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 W GREGORY ST",
            "city": "MOUNT PROSPECT",
            "state": "IL",
            "postal_code": "600562220",
            "telephone_number": "847-394-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROENKE",
        "first_name": "MARY",
        "middle_name": "KATHRYN",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-20",
        "last_updated": "2023-04-02",
        "certification_date": "2023-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "242006495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Prospect, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2023; 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.