Individual provider Active NPI

Dawn R Kovacik, M.A

  • Audiologist
  • Joliet, IL
National Provider Identifier
1366594111
Registry record updated Oct 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
147-000011 Issued in IL
Practice address
3077 W Jefferson St
Ste.206
Joliet, IL 60435-5262
Phone
(815) 744-1214
NPI assigned
Jan 18, 2007
Last updated
Oct 11, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 147-000011 IL Primary

Addresses

Primary practice location

3077 W Jefferson St
Ste.206
Joliet, IL 60435-5262

Mailing address

2800 W Higgins Rd
Ste 895
Hoffman Estates, IL 60169-2071
Phone (847) 843-1900

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
147-000011ILMDAudiologist

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318291200000",
    "number": "1366594111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 W HIGGINS RD",
            "address_2": "STE 895",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601692071",
            "telephone_number": "847-843-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3077 W JEFFERSON ST",
            "address_2": "STE.206",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604355262",
            "telephone_number": "815-744-1214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVACIK",
        "first_name": "DAWN",
        "middle_name": "R",
        "credential": "M.A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2011-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IL",
            "license": "147-000011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.