Individual provider Active NPI

Michael Hefferly, MA

  • Audiologist
  • Chicago, IL
National Provider Identifier
1215101316
Registry record updated Apr 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Practice address
1855 W Taylor St
RM B46
Chicago, IL 60612-7242
Phone
(312) 996-1518
NPI assigned
Apr 18, 2008
Last updated
Apr 18, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 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 IL Primary

Addresses

Primary practice location

1855 W Taylor St
RM B46
Chicago, IL 60612-7242

Mailing address

1855 W Taylor St
RM B46
Chicago, IL 60612-7242
Phone (312) 996-1518

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081215000428 IL Practitioner - Qualified Audiologist 9830251578 Reassigns benefits to 2 organizations

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
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

1411 S Michigan Ave
Chicago, IL 60605-2810

1611 W Harrison St
Chicago, IL 60612-4861

1700 W Van Buren St
Chicago, IL 60612-5500
Phone (312) 563-2875

610 S Maple Ave
Suite 3700
Oak Park, IL 60304-2806
Phone (708) 660-6430

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
147-000644ILMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Group CurrentSince Oct 1, 2018 Accepting new patients
Rush University Medical Center CurrentSince Jun 22, 2024 Accepting new patients
Rush University Medical Center CurrentSince Jun 22, 2024 Accepting new patients

Locations

1411 S Michigan Ave
Chicago, IL 60605
Phone (312) 454-2700

1611 W Harrison St
Ste 530
Chicago, IL 60612
Phone (312) 563-4409

1653 W Congress Pkwy
Ste 739
Chicago, IL 60612
Phone (312) 942-3134

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

1700 W Van Buren St
Ste 161
Chicago, IL 60612
Phone (312) 563-4134

75 Remittance Dr
Dept 1611
Chicago, IL 60675

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1208476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208476800000",
    "number": "1215101316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 W TAYLOR ST",
            "address_2": "RM B46",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127242",
            "telephone_number": "312-996-1518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1855 W TAYLOR ST",
            "address_2": "RM B46",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127242",
            "telephone_number": "312-996-1518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEFFERLY",
        "first_name": "MICHAEL",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-18",
        "last_updated": "2008-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2008; 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.