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Deactivated NPI 1770863771 Deactivated / Inactive NPI Female Practitioner

Stacey Marie Martin

Speech-Language Pathologist • Lisle, 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, Stacey Martin has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 22, 2011
NPI Deactivation Date July 08, 2014
Total Practice Duration ~3 Years of Practice (2011 – 2014)

Professional Overview & Biography Verified Profile Summary

Stacey Martin was a registered Speech-Language Pathologist practicing in Lisle, IL. Throughout an active medical career spanning 3 years, Stacey Martin provided care at the practice location at 1736 MIDDLETON AVENUE until profile deactivation on 2014-07-08.

Practice Location & Contact Primary Location

Practice Address

1736 Middleton Avenue

Lisle, IL 60532

Telephone 6304938076
Fax 6309714069

Specialty Benchmarks & Practice Insights

Comparative analytics for Speech-Language Pathologist in Lisle, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 4.0 Yrs
State Avg: 13.2 Yrs
Regional Practice Density
41 Specialists

Practicing in Lisle, 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 146011200

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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Medical Taxonomy / Specialty Registered (Primary Specialty) April 23, 2018

Speech-Language Pathologist (License #146011200 in IL)

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Updated Practice Location January 30, 2018

Registered at 1736 MIDDLETON AVENUE, LISLE, IL 60532 (Tel: 6304938076)

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Updated Business Mailing Address January 30, 2018

Registered at 1736 MIDDLETON AVENUE, LISLE, IL 60532 (Tel: 6304938076)

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Provider Name / Credentials Updated January 30, 2018

Recorded as STACEY MARTIN

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Medical Taxonomy / Specialty Registered (Primary Specialty) January 30, 2018

Specialist/Technologist (License #242.001933 in IL)

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NPI Profile Reactivated January 29, 2018

Record officially reactivated for active practice on January 29, 2018

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NPI Profile Deactivated July 08, 2014

Record deactivated on July 08, 2014

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Initial NPI Registration & Enumeration August 22, 2011

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: 1770863771
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 22, 2011
Last Update: July 21, 2022
Deactivation Date: July 08, 2014
Sole Proprietor: Yes

Mailing Address

1736 Middleton Avenue

Lisle, IL 60532

Phone: 6304938076

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.