Active NPI
Wendy S Blaine
- Hearing Instrument Specialist
- Joliet, IL
National Provider Identifier
1053893974
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hearing Instrument Specialist
- License
- 3317
- Practice address
- 3143 W Jefferson St
Joliet, IL 60435-4733 - Phone
- (815) 744-6898
- Fax
- (815) 744-2486
- NPI assigned
- Sep 6, 2018
- Last updated
- Feb 27, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hearing Instrument Specialist | 237700000X | 3317 | IL | Primary |
Addresses
Primary practice location
3143 W Jefferson St
Joliet, IL 60435-4733
Mailing address
215 Shuman Blvd Ste 401
Naperville, IL 60563-8123
Phone (630) 303-5380
Other practice location 1
200 E Chicago Ave Ste 102
Westmont, IL 60559-1756
Phone (630) 810-1340
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3317 | IL | MD | Hearing Instrument Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Connect Hearing Inc | Hearing Instrument Specialist | Past | Accepting new patients |
| Connect Hearing, Inc | Hearing Instrument Specialist | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Hearing Aid Equipment
- Downers Grove, IL
- NPI 1275921181
Hearing Instrument Specialist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582761600000",
"number": "1053893974",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 SHUMAN BLVD STE 401",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605638123",
"telephone_number": "630-303-5380",
"fax_number": "630-303-5385"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3143 W JEFFERSON ST",
"city": "JOLIET",
"state": "IL",
"postal_code": "604354733",
"telephone_number": "815-744-6898",
"fax_number": "815-744-2486"
}
],
"practiceLocations": [
{
"address_1": "200 E Chicago Ave Ste 102",
"address_purpose": "LOCATION",
"city": "Westmont",
"state": "IL",
"postal_code": "605591756",
"country_code": "US",
"telephone_number": "630-810-1340",
"fax_number": "630-598-0318",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BLAINE",
"first_name": "WENDY",
"middle_name": "S",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-06",
"last_updated": "2020-02-27",
"certification_date": "2020-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "IL",
"license": "3317",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Joliet, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.