Individual provider Active NPI

Kristin Beth Miller

  • Speech-Language Pathologist
  • Villa Park, IL
National Provider Identifier
1992813901
Registry record updated Apr 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146.009014 Issued in IL
Practice address
830 S Addison Ave
Villa Park, IL 60181-2877
Phone
(630) 620-4433
Fax
(630) 620-1148
NPI assigned
Aug 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2011

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 146.009014 IL Primary

Addresses

Primary practice location

830 S Addison Ave
Villa Park, IL 60181-2877

Mailing address

830 S Addison Ave
Villa Park, IL 60181-2877
Phone (630) 620-4433

Other names 1

  • Kristin Beth Ghilarducci Former name

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
146.009014ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303344000000",
    "number": "1992813901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 S ADDISON AVE",
            "city": "VILLA PARK",
            "state": "IL",
            "postal_code": "601812877",
            "telephone_number": "630-620-4433",
            "fax_number": "630-620-1148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 S ADDISON AVE",
            "city": "VILLA PARK",
            "state": "IL",
            "postal_code": "601812877",
            "telephone_number": "630-620-4433",
            "fax_number": "630-620-1148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KRISTIN",
        "middle_name": "BETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2011-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.009014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "GHILARDUCCI",
            "middle_name": "BETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Villa Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2011; 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.