Marcia Diane Conlisk, M.S.CCC-SLP/L

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146.004683 Issued in IL

Practice address

215 E Washington St
Pontiac, IL 61764-2011

Phone

(815) 844-6131

NPI assigned

Apr 10, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lifelong Access

  • Speech-Language Pathologist
  • Normal, IL
  • NPI 1891701389
  NPD (past)

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

{
    "created_epoch": "1365552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365552000000",
    "number": "1962845784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 9TH AVE",
            "city": "CHENOA",
            "state": "IL",
            "postal_code": "617261299",
            "telephone_number": "217-418-9946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 E WASHINGTON ST",
            "city": "PONTIAC",
            "state": "IL",
            "postal_code": "617642011",
            "telephone_number": "815-844-6131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONLISK",
        "first_name": "MARCIA",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "credential": "M.S.CCC-SLP/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-10",
        "last_updated": "2013-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.004683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Chase, DPT
• Celcilia M Cipriano
• City of Pontiac
• Jordan Collins, DPT
• Jennifer M Conley
• William Edward Copes, BADC
• Julia Eileen Cotter, PEL
• Creamean Chiropractic Clinic
• Terry Lee Creamean
• Ann Christine Crumpler, MSSW LCSW

• Speech-Language Pathologist in Pontiac, IL
• Providers in Pontiac, IL by specialty
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2013; 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.