JENNIFER ANN KICIELINSKI – Speech-Language Pathologist, NPI 1902107782

JENNIFER ANN KICIELINSKI is a healthcare provider. based in Aviston, Illinois. specializing in QUALIFIED SPEECH LANGUAGE PATHOLOGIST. They hold a License No. 146.010646 (IL). The NPI Number for JENNIFER ANN KICIELINSKI is 1902107782

Main info

Female
16 Years Of Experience
Accepts Medicare Assignment
Name
JENNIFER ANN KICIELINSKI
NPI
1902107782
Phone
(618) 228-7682
Address
450 W 1st St
Enumeration Date
9 November 2010
Last Update Date
19 November 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6187069759
Graduation Year
2010 (16 years ago)
PAC ID
6103203195
Group Practice PAC ID
2365718277
Professional Enrollment ID
I20220512001391
Address ID
IL620254282ED7108XRDXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness75
Years active:15State licenses:1Digital endpointsOther names

446 QUALIFIED SPEECH LANGUAGE PATHOLOGIST in IL

Provider Addresses for JENNIFER ANN KICIELINSKI

  • 450 W 1st St

    Aviston, IL 622163440

    Phone: (618) 228-7682

    Type: Location

  • 234 S LIBERTY RD

    TROY, IL 622942830

    Phone: (618) 420-9222

    Type: Mailing

  • 3354 JEROME LN

    CAHOKIA, IL 622062604

    Phone: (618) 337-9400

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-05-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220512001391IQualified Speech Language PathologistILTBD
I20220516001828IQualified Speech Language PathologistMOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
92507Treatment of speech, language, voice, communication, and/or hearing processing disorder9532$0
View full utilization report →

Insurance plans in this area (ZIP 62216)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2365718277View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeIL
Physical Therapist In Private PracticeIL
-IL
Physical Therapist In Private PracticeNY
-MO
Qualified Speech Language PathologistIL
Qualified Speech Language PathologistIN
Physical Therapist In Private PracticeMI
Qualified Speech Language PathologistIN
-IL

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Frequently asked questions

What is the 10-digit NPI for JENNIFER ANN KICIELINSKI?
JENNIFER ANN KICIELINSKI — NPI 1902107782 — is the standard way to identify this listing.
Does CMS list JENNIFER ANN KICIELINSKI as active?
Yes — JENNIFER ANN KICIELINSKI is active in the NPI listing used on this page.
What taxonomy line describes JENNIFER ANN KICIELINSKI?
For research purposes, treat JENNIFER ANN KICIELINSKI as Speech-Language Pathologist in this dataset. Clinical services aligned with this taxonomy classification.
Where is JENNIFER ANN KICIELINSKI based?
JENNIFER ANN KICIELINSKI is tied to Aviston, Illinois in the data we show; additional addresses may exist on the full record.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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