OrganizationActive
Pediatric Fundamentals,llc
NPI 1396155156 · Speech-Language Pathologist · Custer Park, IL
Provider details
- NPI number
- 1396155156
- Entity type
- Organization
- Primary specialty
- Speech-Language PathologistSpeech, Language and Hearing Service Providers
- Organization subpart
- No
- Authorized official
- Shauna Ruzich, Owner/Manager(815) 931-8595
- License
- 146006731 (IL)
Specialties & taxonomies
Speech, Language and Hearing Service Providers
Profile Score
Detailed profile(76/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
36963 Irish Ln
Custer Park, IL 60481-8420
Phone: (815) 931-8595
Street-level locationGet directions
Mailing address
36963 Irish Ln
Custer Park, IL 60481-8420
Registry dates
- Enumerated
- 2014-05-02
- Last updated
- 2014-05-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.