Sherry Fuller

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146011847 Issued in IL

Practice address

2423 Glenwood Ave
Joliet, IL 60435-5483

Phone

(815) 725-9992

Fax

(815) 725-9993

NPI assigned

May 19, 2014

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

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

{
    "created_epoch": "1400457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400457600000",
    "number": "1982015384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22424 ARQUILLA DR",
            "city": "RICHTON PARK",
            "state": "IL",
            "postal_code": "604711537",
            "telephone_number": "708-321-0365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2423 GLENWOOD AVE",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604355483",
            "telephone_number": "815-725-9992",
            "fax_number": "815-725-9993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "SHERRY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-19",
        "last_updated": "2014-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146011847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Joliet, IL
• Providers in Joliet, 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 May 19, 2014; 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.