Individual provider Active NPI

Terese Lynn Falk, M.A.CCC-SLP/L

  • Speech-Language Pathologist
  • Canton, IL
National Provider Identifier
1962928101
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146000776 Issued in IL
Practice address
700 Old West Vine St
Canton, IL 61520-8754
Phone
(309) 647-2111
NPI assigned
Aug 18, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 146000776 IL Primary

Addresses

Primary practice location

700 Old West Vine St
Canton, IL 61520-8754

Mailing address

700 Old West Vine St
Canton, IL 61520-8754
Phone (309) 647-2111

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
146000776ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1503014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1962928101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 OLD WEST VINE ST",
            "city": "CANTON",
            "state": "IL",
            "postal_code": "615208754",
            "telephone_number": "309-647-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 OLD WEST VINE ST",
            "city": "CANTON",
            "state": "IL",
            "postal_code": "615208754",
            "telephone_number": "309-647-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALK",
        "first_name": "TERESE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "M.A.CCC-SLP/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-18",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146000776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.