Individual provider Active NPI

Sandra Siegel, M.A., CCC-A

  • Audiologist
  • Arlington Heights, IL
National Provider Identifier
1205960333
Registry record updated Aug 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
147-000658 Issued in IL
Practice address
880 W Central Rd Ste 4300
Arlington Heights, IL 60005-2381
Phone
(847) 392-2250
Fax
(847) 392-2204
NPI assigned
Mar 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 147-000658 IL Primary
Assistive Technology Practitioner Audiologist 231HA2400X 147-000658 IL
Audiologist-Hearing Aid Fitter 237600000X 147-000658 IL

Addresses

Primary practice location

880 W Central Rd Ste 4300
Arlington Heights, IL 60005-2381

Mailing address

880 W Central Rd Ste 4300
Arlington Heights, IL 60005-2381
Phone (847) 392-2250

Other names 1

  • Ms. Sandra Jaffe Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050503000983 IL Practitioner - Qualified Audiologist 9931149549 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Speech and Hearing Center LTDGroup PAC ID 5890681712, 8 clinicians

Practice addresses (Care Compare)

1100 W Central Rd
Suite 409
Arlington Heights, IL 60005-2468
Phone (847) 392-2250

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
147-000658ILMDAssistive Technology Practitioner Audiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Speech and Hearing Center LTD. Audiologist CurrentSince Apr 18, 2005 Accepting new patients

Locations

880 W Central Rd
Ste 4300
Arlington Heights, IL 60005
Phone (847) 392-2250

1100 W Central Rd
Ste 409
Arlington Hts, IL 60005
Phone (847) 392-0400

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": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344384000000",
    "number": "1205960333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 W CENTRAL RD STE 4300",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600052381",
            "telephone_number": "847-392-2250",
            "fax_number": "847-392-2204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 W CENTRAL RD STE 4300",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600052381",
            "telephone_number": "847-392-2250",
            "fax_number": "847-392-2204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEGEL",
        "first_name": "SANDRA",
        "name_prefix": "Ms.",
        "credential": "M.A., CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2012-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IL",
            "license": "147-000658",
            "primary": true
        },
        {
            "code": "231HA2400X",
            "taxonomy_group": "",
            "desc": "Audiologist, Assistive Technology Practitioner",
            "state": "IL",
            "license": "147-000658",
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "IL",
            "license": "147-000658",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDRA",
            "last_name": "JAFFE",
            "prefix": "MS.",
            "credential": "M.A., CCC-A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Arlington Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2012; 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.