IndividualActive
Basha Ontiveros, M.S., CCC-SLP
NPI 1629083423 · Speech-Language Pathologist · Bloomington, IL
Provider details
- NPI number
- 1629083423
- Entity type
- Individual
- Primary specialty
- Speech-Language PathologistSpeech, Language and Hearing Service Providers
- Credential
- M.S., CCC-SLP
- Sex
- Female
- Sole proprietor
- No
- License
- 146007682 (IL)
Specialties & taxonomies
Speech, Language and Hearing Service Providers
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 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
2416 E Washington St Ste C5
Bloomington, IL 61704-1629
Phone: (913) 730-5925
Fax: (202) 931-7876
Street-level locationGet directions
Mailing address
207 Imperial Dr
Bloomington, IL 61701-2029
Registry dates
- Enumerated
- 2006-07-30
- Last updated
- 2022-08-22
- Certified
- 2022-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.