Candace R Blank, AU.D.

Primary specialty

AudiologistTaxonomy code 231H00000X

License

147000175 Issued in IL

Practice address

2160 S 1St Ave
Department of Audiology
Maywood, IL 60153-3328

Phone

(708) 216-3821

Fax

(708) 216-2137

NPI assigned

Jan 24, 2010

Last updated

Apr 1, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Qualified Audiologist

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Loyola University Medical CenterGroup PAC ID 3779488903, 917 clinicians

Loyola Medical Group LLCGroup PAC ID 6305109547, 124 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Loyola Medical Group LLC

  • General Practice Physician
  • Berwyn, IL
  • NPI 1376041954
  Medicare reassignment Care Compare group NPD
• Loyola University Medical Center

  • General Practice Physician
  • Maywood, IL
  • NPI 1336159961
  Medicare reassignment Care Compare group NPD
• Loyola University Medical Center

  dba Mulcahy Pharmacy

  • Community/Retail Pharmacy
  • Maywood, IL
  • NPI 1184789299
  NPD
• Aggeus Healthcare, P.C.

  • Podiatrist
  • Chicago, IL
  • NPI 1033156955
  NPD (past)
• Asg Onsite Podiatry of Ia 1 PC

  • Podiatrist
  • Chicago, IL
  • NPI 1598016503
  NPD (past)

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

{
    "created_epoch": "1264291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617235200000",
    "number": "1194056564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "address_2": "DEPARTMENT OF AUDIOLOGY",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-3821",
            "fax_number": "708-216-2137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "address_2": "DEPARTMENT OF AUDIOLOGY",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-3821",
            "fax_number": "708-216-2137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANK",
        "first_name": "CANDACE",
        "middle_name": "R",
        "credential": "AU.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-24",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IL",
            "license": "147000175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lblack98256@direct.luhs.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2160 S 1st Ave",
            "address_2": "Department of Audiology",
            "city": "Maywood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601533328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Paul Jerome Bissler, PT, DPT
• Alexander Blachowicz, MD
• Colleen R Blackburn, APRN, CNP
• Amy Rebecca Blair, MD
• Rachel Blanda, MD
• Lindsay Blazek, PA-C
• Matthew J. Blecha, M.D.
• Alec Block
• Cole Block, DO
• Bloom Family Services NFP

• Audiologist in Maywood, IL
• Providers in Maywood, IL by specialty
• Audiologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2021; 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.