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PLAINFIELD COMMUNITY CONSOLIDATED SCHOOL DISTRICT 202 NPI 1205392727


NPI Information

NPI: 1205392727
Provider Name: PLAINFIELD COMMUNITY CONSOLIDATED SCHOOL DISTRICT 202
Classification: Speech-Language Pathologist - 235Z00000X
Entity Type: Organization

CLIA Number: 14D1079021

Address:
2501 MIRAGE AVE
PLAINFIELD, IL
ZIP 60586
Phone: (815) 439-4828
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PLAINFIELD COMMUNITY CONSOLIDATED SCHOOL DISTRICT 202 is a speech language pathologist in Plainfield, IL. The provider is the speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. PLAINFIELD COMMUNITY CONSOLIDATED SCHOOL DISTRICT 202 NPI is 1205392727. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2501 MIRAGE AVE
PLAINFIELD, IL
ZIP 60586-145
Phone: (815) 439-4828

The provider's authorized official is Kelly Whalen .
The authorized official title is Speech Language Pathologist and has the following contact phone number (630) 854-6137.

The CLIA number assigned to this NPI record is 14D1079021 - ancillary testing site in health care center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/20/2019 and was last updated on 2/20/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1235Z00000XSpeech-Language PathologistYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1366005688MEDICAIDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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