Individual provider Active NPI

Diane Marie Schecklong, M.A.

  • Audiologist
  • Dekalb, IL
National Provider Identifier
1164512950
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Practice address
1 Lucinda Ave
Niu Speech-Language Hearing Clinic
Dekalb, IL 60115-2899
Phone
(815) 753-1481
Fax
(815) 753-1664
NPI assigned
Oct 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X IL Primary

Addresses

Primary practice location

1 Lucinda Ave
Niu Speech-Language Hearing Clinic
Dekalb, IL 60115-2899

Mailing address

3014 Fairfield LN
Aurora, IL 60504-3291
Phone (630) 236-6971

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090414000727 IL Practitioner - Qualified Audiologist 3870640501 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northern Illinois UniversityGroup PAC ID 2860440195, 10 clinicians

Practice addresses (Care Compare)

3100 Sycamore Rd
Dekalb, IL 60115-9621
Phone (815) 753-1481

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Illinois University Current Accepting new patients
Northern Illinois University Audiologist Past Accepting new patients

Locations

3100 Sycamore Rd
DeKalb, IL 60115
Phone (815) 752-2675

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164512950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3014 FAIRFIELD LN",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605043291",
            "telephone_number": "630-236-6971",
            "fax_number": "630-236-6972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LUCINDA AVE",
            "address_2": "NIU SPEECH-LANGUAGE HEARING CLINIC",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601152899",
            "telephone_number": "815-753-1481",
            "fax_number": "815-753-1664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHECKLONG",
        "first_name": "DIANE",
        "middle_name": "MARIE",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dekalb, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.