Active NPI
Eleanore Sharon Chan, CF-SLP
- Speech-Language Pathologist
- Decatur, IL
National Provider Identifier
1912482415
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 242.005156
- Practice address
- 136 S Dipper LN
Decatur, IL 62522-1841 - Phone
- (217) 428-7767
- NPI assigned
- Oct 1, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 242.005156 | IL | Primary |
Addresses
Primary practice location
136 S Dipper LN
Decatur, IL 62522-1841
Mailing address
2403 W Springfield Ave Apt T4
Champaign, IL 61821-2858
Phone (312) 451-1456
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 |
|---|---|---|---|
| 242.005156 | IL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1538352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539648000000",
"number": "1912482415",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2403 W SPRINGFIELD AVE APT T4",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618212858",
"telephone_number": "312-451-1456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "136 S DIPPER LN",
"city": "DECATUR",
"state": "IL",
"postal_code": "625221841",
"telephone_number": "217-428-7767"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAN",
"first_name": "ELEANORE",
"middle_name": "SHARON",
"credential": "CF-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-01",
"last_updated": "2018-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "242.005156",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Decatur, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.