Active NPI
Jennifer Marie Castillo
- Speech-Language Pathologist
- Effingham, IL
National Provider Identifier
1912419128
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 146.005693
- Practice address
- 106 W Pine Dr
Effingham, IL 62401-2954 - Phone
- (217) 343-2603
- NPI assigned
- Oct 27, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | |||
| Speech-Language Pathologist | 235Z00000X | 146.005693 | IL | Primary |
Addresses
Primary practice location
106 W Pine Dr
Effingham, IL 62401-2954
Mailing address
106 W Pine Dr
Effingham, IL 62401-2954
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
| License | State | Type | Specialty |
|---|---|---|---|
| 146.005693 | IL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1509062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1509062400000",
"number": "1912419128",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 W PINE DR",
"city": "EFFINGHAM",
"state": "IL",
"postal_code": "624012954"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 W PINE DR",
"city": "EFFINGHAM",
"state": "IL",
"postal_code": "624012954",
"telephone_number": "217-343-2603"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASTILLO",
"first_name": "JENNIFER",
"middle_name": "MARIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-10-27",
"last_updated": "2017-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "146.005693",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Effingham, IL
- Carle Foundation Physician Services, LLC
- Carle Health Care Incorporated
- Carle Health Care Incorporated
- Elizabeth Carroll, MHP
- Larry J Carroll, CRNA, APN
- Central Illinois Oral & Maxillofacial Surgery
- Central Illinois Oral and Maxillofacial Surgery, PC
- Central Illinois Pediatrics LTD
- Central Illinois Pediatrics, LTD
- Cep America Illinois Intensivists
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.