Active NPI
Paige Wydola, AUD
- Audiologist
- Normal, IL
National Provider Identifier
1619405115
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- Practice address
- 207 Landmark Dr
Normal, IL 61761-3195 - Phone
- (309) 268-3200
- NPI assigned
- May 27, 2017
- 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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | Primary |
Addresses
Primary practice location
207 Landmark Dr
Normal, IL 61761-3195
Mailing address
1561 Washington St
Muscatine, IA 52761-5562
Phone (563) 506-4659
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1495843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1542067200000",
"number": "1619405115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1561 WASHINGTON ST",
"city": "MUSCATINE",
"state": "IA",
"postal_code": "527615562",
"telephone_number": "563-506-4659"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "207 LANDMARK DR",
"city": "NORMAL",
"state": "IL",
"postal_code": "617613195",
"telephone_number": "309-268-3200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYDOLA",
"first_name": "PAIGE",
"name_prefix": "Dr.",
"credential": "AUD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-05-27",
"last_updated": "2018-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Normal, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.