Bradley Alan Wicknick, HIS

Primary specialty

Hearing Instrument SpecialistTaxonomy code 237700000X

License

3154 Issued in IL

Practice address

7710 S Cicero Ave
Burbank, IL 60459-1583

Phone

(708) 425-0096

NPI assigned

Mar 26, 2020

Last updated

Mar 26, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Chicago Hearing LLC

  dba Miracle Ear

  • Hearing Aid Equipment
  • Burbank, IL
  • NPI 1972977957
  NPD (past)

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

{
    "created_epoch": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585180800000",
    "number": "1619504834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7710 S CICERO AVE",
            "city": "BURBANK",
            "state": "IL",
            "postal_code": "604591583",
            "telephone_number": "708-425-0096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7710 S CICERO AVE",
            "city": "BURBANK",
            "state": "IL",
            "postal_code": "604591583",
            "telephone_number": "708-425-0096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKNICK",
        "first_name": "BRADLEY",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "HIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-26",
        "last_updated": "2020-03-26",
        "certification_date": "2020-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "IL",
            "license": "3154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jada Walker
• Chang-Yang Wang, M.D.
• Gerald Ward, DDS
• Jeff Watkins
• West Suburban Medical Ctr. (Garden Center)
• Cristine S. Williams, RD, CDE
• Rebecca Wilson, D.O.
• Annabelle Margaret Winters, BCBA
• Kenneth Y Wu, D.D.S.
• Lakshmi Yelamanchili, M.D.

• Hearing Instrument Specialist in Burbank, IL
• Providers in Burbank, IL by specialty
• Hearing Instrument Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2020; 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.