Individual provider Active NPI

Sara Ann Rudolph, AU.D.

  • Audiologist
  • Chicago, IL
National Provider Identifier
1255685160
Registry record updated Oct 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
147.001442 Issued in IL
Practice address
7141 N Kedzie Ave
Apt 113
Chicago, IL 60645-2847
Phone
(773) 290-8239
NPI assigned
Oct 30, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 147.001442 IL Primary

Addresses

Primary practice location

7141 N Kedzie Ave
Apt 113
Chicago, IL 60645-2847

Mailing address

7141 N Kedzie Ave
Apt 113
Chicago, IL 60645-2847

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130403000441 IL Practitioner - Qualified Audiologist 3375788805 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians

Practice addresses (Care Compare)

2701 Patriot Blvd
Glenview, IL 60026-8039
Phone (847) 724-4536

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
147.001442ILMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Mar 1, 2020 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Mar 1, 2020 Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

680 N Lake Shore Dr
Ste 1015
Chicago, IL 60611
Phone (312) 926-9674

680 N Lake Shore Dr
Ste 1000
Chicago, IL 60611
Phone (312) 695-4022

2701 Patriot Blvd
Glenview, IL 60026
Phone (847) 724-4536

800 N Westmoreland Rd
Ste 102
Lake Forest, IL 60045
Phone (847) 295-1300

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1351555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351555200000",
    "number": "1255685160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7141 N KEDZIE AVE",
            "address_2": "APT 113",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606452847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7141 N KEDZIE AVE",
            "address_2": "APT 113",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606452847",
            "telephone_number": "773-290-8239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDOLPH",
        "first_name": "SARA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-30",
        "last_updated": "2012-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IL",
            "license": "147.001442",
            "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 Oct 30, 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.