Active NPI
Fotini Wickman, AUD
- Audiologist
- Hinsdale, IL
National Provider Identifier
1669809869
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 147001186
- Practice address
- 950 N York Rd
Suite 109
Hinsdale, IL 60521-2950 - Phone
- (630) 654-1391
- Fax
- (630) 654-1967
- NPI assigned
- Oct 2, 2013
- 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 | 147001186 | IL | Primary |
Addresses
Primary practice location
950 N York Rd
Suite 109
Hinsdale, IL 60521-2950
Mailing address
950 N York Rd
Suite 109
Hinsdale, IL 60521-2950
Phone (630) 654-1391
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 399980 | Other | IL | MEDICARE GROUP PTAN |
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 |
|---|---|---|---|
| 147001186 | IL | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1422489600000",
"number": "1669809869",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "950 N YORK RD",
"address_2": "SUITE 109",
"city": "HINSDALE",
"state": "IL",
"postal_code": "605212950",
"telephone_number": "630-654-1391",
"fax_number": "630-654-1967"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "950 N YORK RD",
"address_2": "SUITE 109",
"city": "HINSDALE",
"state": "IL",
"postal_code": "605212950",
"telephone_number": "630-654-1391",
"fax_number": "630-654-1967"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WICKMAN",
"first_name": "FOTINI",
"credential": "AUD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-10-02",
"last_updated": "2015-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "IL",
"license": "147001186",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP PTAN",
"identifier": "399980",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hinsdale, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.