Central Illinois Speech Therapy

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

CENTRAL ILLINOIS SPEECH THERAPY

Practice address

4 Holder Way
Bloomington, IL 61704-8152

Phone

(309) 212-4862

NPI assigned

Nov 2, 2015

Last updated

Nov 2, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Karen Lara Dudek-Brannan, ED.D. CCC-SLP/LNPI 1528187697

Title

Speech Language Pathologist

Phone

(309) 212-4862

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Karen Lara Dudek-Brannan, ED.D. CCC-SLP

  • Speech-Language Pathologist
  • Bloomington, IL
  • NPI 1528187697
  NPD (past) Authorized official

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

{
    "created_epoch": "1446422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446422400000",
    "number": "1962875872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 HOLDER WAY",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617048152",
            "telephone_number": "309-212-4862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 HOLDER WAY",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617048152",
            "telephone_number": "309-212-4862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL ILLINOIS SPEECH THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-02",
        "last_updated": "2015-11-02",
        "status": "A",
        "authorized_official_last_name": "DUDEK-BRANNAN",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "LARA",
        "authorized_official_title_or_position": "SPEECH LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "309-212-4862",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ED.D. CCC-SLP/L"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Central Illinois Neuroradiology, LTD
• Central Illinois Orthopedic Surgery II LLC.
• Central Illinois Orthopedic Surgery S.C.
• Central Illinois Pediatric Associates LLC
• Central Illinois Preventive Services LLC
• Cep America-Illinois Hospitalists
• Cepamerica Illinois LLP
• Abigail G Cervantes, APN
• Chad Tattini, MD LLC
• Vicken S Chalian, M.D.

• Speech-Language Pathologist in Bloomington, IL
• Providers in Bloomington, 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 Nov 2, 2015; 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.