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Deactivated NPI 1164111498 Deactivated / Inactive NPI Female Practitioner

Marie Therese Clare Bonomo

Speech-Language Pathologist • Channahon, IL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Marie Bonomo has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date May 03, 2023
NPI Deactivation Date May 02, 2024
Total Practice Duration ~1 Years of Practice (2023 – 2024)

Professional Overview & Biography Verified Profile Summary

Marie Bonomo was a registered Speech-Language Pathologist practicing in Channahon, IL. Throughout an active medical career spanning 1 years, Marie Bonomo provided care at the practice location at 26655 W EAMES ST until profile deactivation on 2024-05-02.

Practice Location & Contact Primary Location

Practice Address

26655 W Eames St

Channahon, IL 604105380

Telephone 8155214001

Specialty Benchmarks & Practice Insights

Comparative analytics for Speech-Language Pathologist in Channahon, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 13.2 Yrs
Regional Practice Density
9 Specialists

Practicing in Channahon, IL (10321 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

State License IL 146.015616

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.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
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NPI Profile Deactivated May 02, 2024

Record deactivated on May 02, 2024

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NPI Profile Deactivated May 01, 2024

Record deactivated on May 01, 2024

NPI Profile Active May 03, 2023

NPI status registered as active in NPPES database

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Updated Practice Location May 03, 2023

Registered at 26655 W EAMES ST, CHANNAHON, IL 604105380 (Tel: 8155214001)

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Updated Business Mailing Address May 03, 2023

Registered at 750 PHEASANT LN, COAL CITY, IL 604162418 (Tel: 8153413489)

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Provider Name / Credentials Updated May 03, 2023

Recorded as MARIE BONOMO

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Medical Taxonomy / Specialty Registered (Primary Specialty) May 03, 2023

Speech-Language Pathologist (License #146.015616 in IL)

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Initial NPI Registration & Enumeration May 03, 2023

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1164111498
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 03, 2023
Last Update: May 03, 2023
Deactivation Date: May 02, 2024

Mailing Address

750 Pheasant Ln

Coal City, IL 604162418

Phone: 8153413489

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.