Individual provider Active NPI

Ilana Sidorow

  • Speech-Language Pathologist
  • Arlington, VA
National Provider Identifier
1952176562
Registry record updated Nov 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202011023 Issued in VA
Practice address
2600 Crystal Dr Apt 1024
Arlington, VA 22202-3574
Phone
(630) 781-6390
NPI assigned
Nov 24, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2023

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 2202011023 VA Primary

Addresses

Primary practice location

2600 Crystal Dr Apt 1024
Arlington, VA 22202-3574

Mailing address

2600 Crystal Dr Apt 1024
Arlington, VA 22202-3574
Phone (630) 781-6390

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

LicenseStateTypeSpecialty
2202011023VAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1700784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700784000000",
    "number": "1952176562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 CRYSTAL DR APT 1024",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222023574",
            "telephone_number": "630-781-6390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 CRYSTAL DR APT 1024",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222023574",
            "telephone_number": "630-781-6390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDOROW",
        "first_name": "ILANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-24",
        "last_updated": "2023-11-24",
        "certification_date": "2023-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202011023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2023; 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.