Active NPI
Nedra Marie Lee
- Speech-Language Pathologist
- Hazel Crest, IL
National Provider Identifier
1922269752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 146.004476
- Practice address
- 3626 Tamarind LN
Hazel Crest, IL 60429-1555 - Phone
- (708) 335-4557
- Fax
- (773) 471-5284
- NPI assigned
- Jun 24, 2008
- 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 | 146.004476 | IL | Primary |
Addresses
Primary practice location
3626 Tamarind LN
Hazel Crest, IL 60429-1555
Mailing address
3626 Tamarind LN
Hazel Crest, IL 60429-1555
Phone (708) 335-4557
Other names 1
- Miss Nedra Marie Young
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 |
|---|---|---|---|
| 146.004476 | IL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214265600000",
"number": "1922269752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3626 TAMARIND LN",
"city": "HAZEL CREST",
"state": "IL",
"postal_code": "604291555",
"telephone_number": "708-335-4557",
"fax_number": "773-471-5284"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3626 TAMARIND LN",
"city": "HAZEL CREST",
"state": "IL",
"postal_code": "604291555",
"telephone_number": "708-335-4557",
"fax_number": "773-471-5284"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "NEDRA",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-24",
"last_updated": "2008-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "146.004476",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "NEDRA",
"last_name": "YOUNG",
"middle_name": "MARIE",
"prefix": "MISS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Hazel Crest, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.