NPI Code Detail JSON Logo

1700036563 NPI number — JACQUELINE ANNE RUDEWICZ M.S.P. CCC-SLP/L

NPI Number: 1700036563
Health Care Provider/Practitioner: JACQUELINE ANNE RUDEWICZ M.S.P. CCC-SLP/L

Information about “1700036563” NPI (JACQUELINE ANNE RUDEWICZ M.S.P. CCC-SLP/L) exists in 1700036563 in HTML format HTML  |  1700036563 in plain Text format TXT  |  1700036563 in PDF (Portable Document Format) PDF  |  1700036563 in an XML format XML  formats.

NPI Number : 1700036563 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1700036563",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "RUDEWICZ",
    "FirstName": "JACQUELINE",
    "MiddleName": "ANNE",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "M.S.P. CCC-SLP/L",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "SEIMS",
    "OtherFirstName": "JACQUELINE",
    "OtherMiddleName": "ANNE",
    "OtherNamePrefix": "MISS",
    "OtherNameSuffix": null,
    "OtherCredential": "M.S.P. CCC-SLP/L",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "434 W WELLINGTON AVE",
    "SecondLineMailingAddress": "APT. 308",
    "MailingAddressCityName": "CHICAGO",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "60657-5820",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "352-665-0326",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "434 W WELLINGTON AVE",
    "SecondLinePracticeLocationAddress": "APT. 308",
    "PracticeLocationAddressCityName": "CHICAGO",
    "PracticeLocationAddressStateName": "IL",
    "PracticeLocationAddressPostalCode": "60657-5820",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "352-665-0326",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "09/29/2008",
    "LastUpdateDate": "09/29/2008",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "235Z00000X",
        "TaxonomyName": "Speech-Language Pathologist",
        "LicenseNumber": "146.009450",
        "LicenseNumberStateCode": "IL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.