NPIMap

Organization Active NPI

Illinois State University

Doing business as Speech & Hearing Clinic

  • Audiologist-Hearing Aid Fitter
  • Normal, IL
National Provider Identifier
1669616983
Registry record updated Oct 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
Legal business name
ILLINOIS STATE UNIVERSITY
Doing business as
Speech & Hearing Clinic
Practice address
275 S University St
Campus Box 4720
Normal, IL 61790-4720
Phone
(309) 438-8641
Fax
(309) 438-0575
NPI assigned
Apr 30, 2009
Last updated
Oct 16, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2014

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

Authorized official

Name
Mrs. Heidi VerticchioNPI 1386991941
Title
Clinic Director
Phone
(309) 438-3266

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X Primary

Addresses

Primary practice location

275 S University St
Campus Box 4720
Normal, IL 61790-4720

Mailing address

275 S University St
Campus Box 4720
Normal, IL 61790-4720
Phone (309) 438-8641

Other names 1

  • Speech & Hearing Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141230000271 IL Part B Supplier - Clinic/Group Practice 5597088492 Receives reassigned benefits from 14 practitioners
Practice locations: Normal, IL

National Provider Directory

National Provider Directory
Tax ID family
Illinois State University4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

275 S University St
Normal, IL 61790

4720 Campus
Normal, IL 61790

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1241049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413417600000",
    "number": "1669616983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 S UNIVERSITY ST",
            "address_2": "CAMPUS BOX 4720",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617904720",
            "telephone_number": "309-438-8641",
            "fax_number": "309-438-0575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 S UNIVERSITY ST",
            "address_2": "CAMPUS BOX 4720",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617904720",
            "telephone_number": "309-438-8641",
            "fax_number": "309-438-0575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS STATE UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-30",
        "last_updated": "2014-10-16",
        "status": "A",
        "authorized_official_last_name": "VERTICCHIO",
        "authorized_official_first_name": "HEIDI",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "309-438-3266",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Speech & Hearing Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.