Individual provider Active NPI

Mary Ann Jordan

  • Audiologist
  • Niles, IL
National Provider Identifier
1144479064
Registry record updated Sep 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
147.000217 Issued in IL
Practice address
8780 W Golf Rd
Suite 200
Niles, IL 60714-5602
Phone
(847) 824-1712
NPI assigned
Sep 16, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 147.000217 IL Primary

Addresses

Primary practice location

8780 W Golf Rd
Suite 200
Niles, IL 60714-5602

Mailing address

1235 Belleforte Ave
Oak Park, IL 60302-1201
Phone (708) 386-5935

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
147.000217ILMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ear, Nose & Throat Specialists of Illinois LTD CurrentSince Oct 1, 2008 Accepting new patients
Midwest ENT Alliance PLLC CurrentSince Nov 1, 2024 Accepting new patients
Bastian Voice Institute, LLC PastSince Sep 22, 2003 Accepting new patients

Locations

3010 Highland Pkwy
Ste 550
Downers Grove, IL 60515
Phone (630) 724-1100

1900 Hollister Dr
Ste 220
Libertyville, IL 60048
Phone (847) 367-4040

8780 W Golf Rd
Ste 200
Niles, IL 60714
Phone (847) 824-4390

2604 Dempster St
Ste 501
Park Ridge, IL 60068
Phone 8476745585111

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1221523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221523200000",
    "number": "1144479064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1235 BELLEFORTE AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603021201",
            "telephone_number": "708-386-5935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8780 W GOLF RD",
            "address_2": "SUITE 200",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607145602",
            "telephone_number": "847-824-1712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "MARY ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-16",
        "last_updated": "2008-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IL",
            "license": "147.000217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2008; 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.