Active NPI
Matthew Walk, H.I.S.
- Hearing Instrument Specialist
- Crestwood, IL
National Provider Identifier
1104376516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hearing Instrument Specialist
- License
- EH 016703
- Practice address
- 5553 127TH St
Crestwood, IL 60445-1123 - Phone
- (815) 513-5268
- Fax
- (815) 942-1851
- NPI assigned
- Oct 10, 2016
- Sex
- Male
- 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 | EH 016703 | IL | Primary |
Addresses
Primary practice location
5553 127TH St
Crestwood, IL 60445-1123
Mailing address
5553 127TH St
Crestwood, IL 60445-1123
Phone (815) 513-5268
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 |
|---|---|---|---|
| EH 016703 | IL | MD | Hearing Instrument Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1476057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476057600000",
"number": "1104376516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5553 127TH ST",
"city": "CRESTWOOD",
"state": "IL",
"postal_code": "604451123",
"telephone_number": "815-513-5268",
"fax_number": "815-942-1851"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5553 127TH ST",
"city": "CRESTWOOD",
"state": "IL",
"postal_code": "604451123",
"telephone_number": "815-513-5268",
"fax_number": "815-942-1851"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALK",
"first_name": "MATTHEW",
"name_prefix": "Mr.",
"credential": "H.I.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-10-10",
"last_updated": "2016-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "IL",
"license": "EH 016703",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crestwood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.