Individual provider Active NPI

Caitlin R. Gregory

  • Speech-Language Assistant
  • Forest Park, IL
National Provider Identifier
1992515126
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
217.000507 Issued in IL
Practice address
818 Hannah Ave
Forest Park, IL 60130-2006
Phone
(231) 631-0857
NPI assigned
Jan 9, 2025
Last updated
Jan 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X 217.000507 IL Primary

Addresses

Primary practice location

818 Hannah Ave
Forest Park, IL 60130-2006

Mailing address

818 Hannah Ave
Forest Park, IL 60130-2006
Phone (231) 631-0857

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
217.000507ILMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1736380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1992515126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 HANNAH AVE",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601302006",
            "telephone_number": "231-631-0857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 HANNAH AVE",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601302006",
            "telephone_number": "231-631-0857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGORY",
        "first_name": "CAITLIN",
        "middle_name": "R.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-09",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "IL",
            "license": "217.000507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; 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.