Independent US Healthcare Provider Directory & Public Medical Database Patient Guides

Jaclyn Ann Sullivan

Speech-Language Pathologist β€’ Palos Park, IL

Active NPI 1700432424 Individual Practitioner Female Practitioner
Practice location in NPPES

12910 S La Grange Rd
Palos Park, IL 604641717

Call 7084481234 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

12910 S La Grange Rd

Palos Park, IL 604641717

Telephone 7084481234
Organization at the Same NPPES Address or Phone
Stevens Enterprises Inc. Facility NPI 1841599263

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2019

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Jaclyn Sullivan has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Compared with the same specialty in Palos Park and Illinois

12 active clinicians are listed under Speech-Language Pathologist with a practice address in Palos Park, IL (10,226 in Illinois).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Palos Park

0% of these 12 clinicians have the CMS telehealth indicator.

8.3% of these 12 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2024-04-24
Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

License # reported to NPPES IL 146.011457

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.

Hearing Instrument Specialist

NUCC Taxonomy Code: 237700000X

License # reported to NPPES IL 2676

Individuals who test hearing for the selection, adaptation, fitting, adjusting, servicing, and sale of hearing aids. Hearing Instrument Specialist is a designation provided individuals who qualify by the National Hearing Aid Society

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Illinois Department of Financial and Professional Regulation.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - QUALIFIED SPEECH LANGUAGE PATHOLOGIST

Medicare Enrollment ID

I20240405001993

Enrollment State Jurisdiction

IL

PECOS Control ID

7416395744

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

9 Historical Events
πŸ“
Updated Practice Location April 24, 2024

Registered at 12910 S LA GRANGE RD, PALOS PARK, IL 604641717 (Tel: 7084481234)

πŸ“
Updated Business Mailing Address April 24, 2024

Registered at 12910 S LA GRANGE RD, PALOS PARK, IL 604641717 (Tel: 7084481234)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) April 24, 2024

Hearing Instrument Specialist (license number reported to NPPES: IL 2676)

βœ…
NPI Profile Active August 18, 2019

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) August 18, 2019

Registered at 17833 HARLEM AVE, TINLEY PARK, IL 604773605 (Tel: 7087824077)

πŸ“
Business Mailing Address (Initial Record) August 18, 2019

Registered at 21223 SAGE BRUSH LN, MOKENA, IL 604481488 (Tel: 7088458912)

πŸ‘€
Provider Name / Credentials (Initial Record) August 18, 2019

Recorded as JACLYN SULLIVAN

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) August 18, 2019

Speech-Language Pathologist (license number reported to NPPES: IL 146011457)

🟒
Initial NPI Registration & Enumeration August 18, 2019

First registered as active Individual Practitioner in NPPES Database.

No reviews have been published yet. Leave a review.

NPI Administrative Meta

NPI Number: 1700432424
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 18, 2019
Last Update: April 24, 2024
Sole Proprietor: No

Mailing Address

12910 S La Grange Rd

Palos Park, IL 604641717

Phone: 7084481234

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.