Annelise Thifault

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

242.004652 Issued in IL

Practice address

2525 Ohio Pkwy
Rockford, IL 61108-7517

Phone

(815) 229-2800

NPI assigned

Nov 15, 2017

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1510704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510704000000",
    "number": "1912410663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "273 CORDIAL DR",
            "city": "BRIDGEVILLE",
            "state": "PA",
            "postal_code": "150171133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 OHIO PKWY",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611087517",
            "telephone_number": "815-229-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIFAULT",
        "first_name": "ANNELISE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-15",
        "last_updated": "2017-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "242.004652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Inspiration and Life Enhancement
• The Lotus Center
• Tabitha Mae Theiler, RST, CST
• Timothy Allen Theisen, DDS, MS
• Theodore S. Ingrassia, III, M.D.S.C.
• Jennifer Thilges, APRN
• Thinfast MD Rockford
• David T Thom, DPM
• Sylvia Thoman, O.D.
• Thomas a Runne DPM LTD

• All providers in Rockford, IL
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2017; 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.