Individual provider Active NPI

Kelly C Esparza, AU.D.

  • Audiologist
  • Chicago, IL
National Provider Identifier
1083942213
Registry record updated Nov 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
147001320 Issued in IL
Practice address
5835 S Cottage Grove Ave
Dcam 4754
Chicago, IL 60637-1416
Phone
(773) 834-7102
NPI assigned
Nov 30, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 147001320 IL Primary

Addresses

Primary practice location

5835 S Cottage Grove Ave
Dcam 4754
Chicago, IL 60637-1416

Mailing address

2440 Budd St
River Grove, IL 60171-1735
Phone (312) 213-3075

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

LicenseStateTypeSpecialty
147001320ILMDAudiologist

NPI Registry JSON

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

{
    "created_epoch": "1259539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259539200000",
    "number": "1083942213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 BUDD ST",
            "city": "RIVER GROVE",
            "state": "IL",
            "postal_code": "601711735",
            "telephone_number": "312-213-3075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5835 S COTTAGE GROVE AVE",
            "address_2": "DCAM 4754",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371416",
            "telephone_number": "773-834-7102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESPARZA",
        "first_name": "KELLY",
        "middle_name": "C",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-30",
        "last_updated": "2009-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IL",
            "license": "147001320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2009; 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.