Individual provider Active NPI

Spencer Stanesa, AUD

  • Audiologist
  • Normal, IL
National Provider Identifier
1700619574
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
147002015 Issued in IL
Practice address
207 Landmark Dr Ste a
Normal, IL 61761-3195
Phone
(309) 268-3200
Fax
(309) 268-3213
NPI assigned
Aug 26, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 147002015 IL Primary

Addresses

Primary practice location

207 Landmark Dr Ste a
Normal, IL 61761-3195

Mailing address

611 W Park St
Urbana, IL 61801-2501
Phone (217) 902-6954

Other practice location 1

8600 State Route 91 Ste 300
Peoria, IL 61615-7832
Phone (309) 691-6616

Other practice location 2

200 E Pennsylvania Ave
Peoria, IL 61603-3089
Phone (309) 624-4000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241007002760 IL Practitioner - Qualified Audiologist 9234660804 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians
Carle West Physician Group IncGroup PAC ID 8921420308, 282 clinicians

Practice addresses (Care Compare)

207 Landmark Dr
Suite a
Normal, IL 61761-3195
Phone (309) 268-3212

2204 Eastland Dr
Bloomington, IL 61704-3567
Phone (309) 663-0222

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Carle Health Care Incorporated CurrentSince Oct 4, 2025 Accepting new patients
Saint Francis Medical Center Current Accepting new patients
Carle West Physician Group Inc CurrentSince Apr 4, 2025 Accepting new patients

Locations

2204 Eastland Dr
Bloomington, IL 61704
Phone (309) 662-9461

3310 Fields South Dr
Champaign, IL 61822
Phone (217) 417-2352

207 Landmark Dr
Ste A
Normal, IL 61761
Phone (309) 268-3200

530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1724630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1700619574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012501",
            "telephone_number": "217-902-6954",
            "fax_number": "217-902-7711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 LANDMARK DR STE A",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617613195",
            "telephone_number": "309-268-3200",
            "fax_number": "309-268-3213"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8600 State Route 91 Ste 300",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "IL",
            "postal_code": "616157832",
            "country_code": "US",
            "telephone_number": "309-691-6616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 E Pennsylvania Ave",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "IL",
            "postal_code": "616033089",
            "country_code": "US",
            "telephone_number": "309-624-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STANESA",
        "first_name": "SPENCER",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-26",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IL",
            "license": "147002015",
            "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 May 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.