Active NPI
Brenda Frances Harris, SLP-L
- Speech-Language Pathologist
- Sauk Village, IL
National Provider Identifier
1992052484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 146-005954
- Practice address
- 1807 222ND PL
Sauk Village, IL 60411-5047 - Phone
- (708) 757-9237
- NPI assigned
- Aug 14, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 146-005954 | IL | Primary |
Addresses
Primary practice location
1807 222ND PL
Sauk Village, IL 60411-5047
Mailing address
18656 Dixie Hwy
Homewood, IL 60430-3729
Phone (708) 323-7057
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 146-005954 | Other | IL | IL STATE LICENSE, SPEECH PATHOLOGY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 146-005954 | IL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1344902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344902400000",
"number": "1992052484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18656 DIXIE HWY",
"city": "HOMEWOOD",
"state": "IL",
"postal_code": "604303729",
"telephone_number": "708-323-7057"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1807 222ND PL",
"city": "SAUK VILLAGE",
"state": "IL",
"postal_code": "604115047",
"telephone_number": "708-757-9237"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "BRENDA",
"middle_name": "FRANCES",
"name_prefix": "Ms.",
"credential": "SLP-L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-08-14",
"last_updated": "2012-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "146-005954",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IL STATE LICENSE, SPEECH PATHOLOGY",
"identifier": "146-005954",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sauk Village, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.