North Side Audiology Group, Inc.

Primary specialty

AudiologistTaxonomy code 231H00000X

License

147000241 Issued in IL

Legal business name

NORTH SIDE AUDIOLOGY GROUP, INC.

Practice address

4200 W. Peterson Ave.
Suite 100
Chicago, IL 60646-6052

Phone

(773) 777-3277

Fax

(773) 777-2878

NPI assigned

Mar 8, 2007

Last updated

Dec 7, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Daria T Popowych, MS CCCANPI 1679610596

Title

Audiologist

Phone

(773) 777-3277

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Daria Popowych, M.S., CCC-A

  • Audiologist
  • Chicago, IL
  • NPI 1679610596
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354838400000",
    "number": "1053442491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 W. PETERSON AVE.",
            "address_2": "SUITE 100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606466052",
            "telephone_number": "773-777-3277",
            "fax_number": "773-777-2878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 W. PETERSON AVE.",
            "address_2": "SUITE 100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606466052",
            "telephone_number": "773-777-3277",
            "fax_number": "773-777-2878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SIDE AUDIOLOGY GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2012-12-07",
        "status": "A",
        "authorized_official_last_name": "POPOWYCH",
        "authorized_official_first_name": "DARIA",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "AUDIOLOGIST",
        "authorized_official_telephone_number": "773-777-3277",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS CCCA"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IL",
            "license": "147000241",
            "primary": true
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IL",
            "license": "147000271",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "333608331001",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "265496573001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• North Shore Optical Inc.
• North Shore Optical Inc. (North Vision Center)
• North Shore Physicians Group, LLC
• North Shore Psychotherapy, PLLC
• North Shore Smile Studio LLC (Water Tower Dental Care)
• North Side Neurology SC
• North Star Clinical Therapy PLLC
• North Star Pharmacy Inc (Rosenblum Drug)
• North Suburban Associated Physicians, Inc.
• North Suburban Orthodontics, LTD

• Audiologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Audiologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.