Active NPI
Audrey K Aeilts
- Professional Counselor
- Champaign, IL
National Provider Identifier
1316510290
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 178.016310
- Practice address
- 309 W Clark St
Champaign, IL 61820-4637 - Phone
- (217) 398-9066
- Fax
- (217) 398-9077
- NPI assigned
- Jul 20, 2021
- Last updated
- Jul 28, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 178.016310 | IL | Primary |
Addresses
Primary practice location
309 W Clark St
Champaign, IL 61820-4637
Mailing address
309 W Clark St
Champaign, IL 61820-4637
Phone (217) 398-9066
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 178.016310 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627430400000",
"number": "1316510290",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "309 W CLARK ST",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618204637",
"telephone_number": "217-398-9066",
"fax_number": "217-398-9077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "309 W CLARK ST",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618204637",
"telephone_number": "217-398-9066",
"fax_number": "217-398-9077"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AEILTS",
"first_name": "AUDREY",
"middle_name": "K",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-20",
"last_updated": "2021-07-28",
"certification_date": "2021-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "178.016310",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Champaign, IL
- Ghada Adhami, DDS
- Andrew Adiputra
- Advanced Aesthetics Surgery & Laser Center, P.C.
- Advanced Chiropractic and Rehabilitation Center, P.C.
- Advanced Medical Transport East Inc. (AMT East)
- Affiliates in Oral & Maxillofacial Surgery LTD
- Affinity Dental Champaign LLC (Affinity Family Dental Champaign)
- Affordable Dentistry Today, PC (Affordable Dentistry Today - Champaign)
- Affordable Dentures & Implants - Champaign, P.C.
- Brandon Aguiar, LSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.