Individual provider Active NPI

Kristin Beintum

  • Speech-Language Pathologist
  • Oswego, IL
National Provider Identifier
1992945125
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146.006744 Issued in IL
Practice address
4175 Route 71
Oswego, IL 60543-8340
Phone
(630) 636-3080
NPI assigned
Feb 27, 2009
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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
146.006744ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Oswego Community Unit School District 308 PastSince Aug 25, 2024 Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 146.006744 IL Primary

Addresses

NPPES NPI Registry

Primary practice location

4175 Route 71
Oswego, IL 60543-8340

Mailing address

6806 Desert Dr
Plainfield, IL 60586-6592

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 20, 2024.

{
    "created_epoch": "1235692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1992945125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6806 DESERT DR",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605866592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4175 ROUTE 71",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "605438340",
            "telephone_number": "630-636-3080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEINTUM",
        "first_name": "KRISTIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-27",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.006744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oswego, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; 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.