Active NPI
Holly Pietrzak-Slazakowski, DT
- Developmental Therapist
- Marengo, IL
National Provider Identifier
1992472054
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Therapist
- Practice address
- 440 Kennedy St
Marengo, IL 60152-9026 - Phone
- (815) 814-7090
- NPI assigned
- Aug 26, 2021
- Last updated
- Aug 26, 2021
- 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 |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | IL | Primary |
Addresses
Primary practice location
440 Kennedy St
Marengo, IL 60152-9026
Mailing address
440 Kennedy St
Marengo, IL 60152-9026
Phone (815) 814-7090
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Holly |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629936000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629936000000",
"number": "1992472054",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "440 KENNEDY ST",
"city": "MARENGO",
"state": "IL",
"postal_code": "601529026",
"telephone_number": "815-814-7090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "440 KENNEDY ST",
"city": "MARENGO",
"state": "IL",
"postal_code": "601529026",
"telephone_number": "815-814-7090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PIETRZAK-SLAZAKOWSKI",
"first_name": "HOLLY",
"credential": "DT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-08-26",
"last_updated": "2021-08-26",
"certification_date": "2021-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Holly",
"affiliation": "N",
"address_1": "440 Kennedy St",
"city": "Marengo",
"state": "IL",
"country_code": "US",
"postal_code": "601529026",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Marengo, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.