Steven C Bourgeois, MA, CCC-A

Primary specialty

AudiologistTaxonomy code 231H00000X

License

AUD003412 Issued in GA

Practice address

1020 11TH Ave
Great Lakes, IL 60088-3102

Phone

(847) 688-5568

Fax

(847) 688-4430

NPI assigned

Jan 6, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053399345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2026 OAK TREE TRL",
            "city": "LAKE VILLA",
            "state": "IL",
            "postal_code": "600467566",
            "telephone_number": "847-331-4669",
            "fax_number": "413-647-4096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 11TH AVE",
            "city": "GREAT LAKES",
            "state": "IL",
            "postal_code": "600883102",
            "telephone_number": "847-688-5568",
            "fax_number": "847-688-4430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURGEOIS",
        "first_name": "STEVEN",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "MA, CCC-A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "GA",
            "license": "AUD003412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Audiologist in Great Lakes, IL
• Providers in Great Lakes, IL by specialty
• Audiologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.