Organization Active NPI

School Street Speech, LLC

  • Speech-Language Pathologist
  • Libertyville, IL
National Provider Identifier
1922464031
Registry record updated Jan 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146.011970 Issued in IL
Legal business name
SCHOOL STREET SPEECH, LLC
Practice address
143 School St
Libertyville, IL 60048-2026
Phone
(224) 628-5461
Fax
(844) 965-9865
NPI assigned
Jan 5, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2016

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

Authorized official

Name
Naomi R Nordell, MA CCC-SLP
Title
Speech-Language Pathologist
Phone
(224) 628-5461

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 146.011970 IL Primary

Addresses

Primary practice location

143 School St
Libertyville, IL 60048-2026

Mailing address

143 School St
Libertyville, IL 60048-2026
Phone (224) 628-5461

Other identifiers 1

IdentifierTypeStateIssuer
1700259439OtherILINDIVIDUAL PROVIDER NPI NUMBER (TYPE 1)

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1451952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451952000000",
    "number": "1922464031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 SCHOOL ST",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600482026",
            "telephone_number": "224-628-5461",
            "fax_number": "844-965-9865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 SCHOOL ST",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600482026",
            "telephone_number": "224-628-5461",
            "fax_number": "844-965-9865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCHOOL STREET SPEECH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-05",
        "last_updated": "2016-01-05",
        "status": "A",
        "authorized_official_last_name": "NORDELL",
        "authorized_official_first_name": "NAOMI",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "224-628-5461",
        "authorized_official_credential": "MA CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.011970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL PROVIDER NPI NUMBER (TYPE 1)",
            "identifier": "1700259439",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2016; 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.