Individual provider Active NPI

Jeffrey Wayne Wise, AUD

  • Audiologist
  • Evanston, IL
National Provider Identifier
1164043188
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Practice address
731 Chicago Ave
Evanston, IL 60202-2310
Phone
(224) 350-2550
NPI assigned
Apr 30, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X Primary

Addresses

Primary practice location

731 Chicago Ave
Evanston, IL 60202-2310

Mailing address

731 Chicago Ave
Evanston, IL 60202-2310
Phone (224) 350-2550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230928003005 IL Practitioner - Qualified Audiologist 5395166151 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wise Hearing Care PLLCGroup PAC ID 3870947542, 2 clinicians

Practice addresses (Care Compare)

1939 Waukegan Rd
Suite 102
Glenview, IL 60025-1757
Phone (224) 350-2550

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wise Hearing Care, PLLC Audiologist CurrentSince May 1, 2023 Accepting new patients

Locations

731 Chicago Ave
Evanston, IL 60202
Phone (224) 350-2550

1939 Waukegan Rd
Ste 102
Glenview, IL 60025
Phone (224) 350-2550

Organizations & group practices 1

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": "1588204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1164043188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 CHICAGO AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602022310",
            "telephone_number": "224-350-2550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 CHICAGO AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602022310",
            "telephone_number": "224-350-2550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "JEFFREY",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-30",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.