Individual provider Active NPI

Holly B Mulvenna, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Chicago, IL
National Provider Identifier
1922258557
Registry record updated Sep 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146006538 Issued in IL
Practice address
2307 W Roscoe St
Unit 1W
Chicago, IL 60618-6245
Phone
(773) 972-0864
NPI assigned
Sep 18, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2008

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 146006538 IL Primary

Addresses

Primary practice location

2307 W Roscoe St
Unit 1W
Chicago, IL 60618-6245

Mailing address

2307 W Roscoe St
Unit 1W
Chicago, IL 60618-6245
Phone (773) 972-0864

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 Arts

State licenses

LicenseStateTypeSpecialty
146006538ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1221696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221696000000",
    "number": "1922258557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2307 W ROSCOE ST",
            "address_2": "UNIT 1W",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606186245",
            "telephone_number": "773-972-0864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2307 W ROSCOE ST",
            "address_2": "UNIT 1W",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606186245",
            "telephone_number": "773-972-0864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULVENNA",
        "first_name": "HOLLY",
        "middle_name": "B",
        "name_prefix": "Mrs.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-18",
        "last_updated": "2008-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146006538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2008; 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.