Individual provider Active NPI

Mark Scott Christian, AU.D.

  • Audiologist
  • Deerfield, IL
National Provider Identifier
1710005699
Registry record updated Apr 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
147-001042 Issued in IL
Practice address
400 Lake Cook Rd
Suite 106
Deerfield, IL 60015-5607
Phone
(847) 940-9891
Fax
(847) 964-9343
NPI assigned
Mar 27, 2007
Last updated
Apr 15, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 147-001042 IL Primary

Addresses

Primary practice location

400 Lake Cook Rd
Suite 106
Deerfield, IL 60015-5607

Mailing address

400 Lake Cook Rd
Suite 106
Deerfield, IL 60015-5607
Phone (847) 940-9891

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151201000152 IL Practitioner - Qualified Audiologist 1658671433 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Audiology Associates of Deerfield, PCGroup PAC ID 6204924194, 2 clinicians

Practice addresses (Care Compare)

400 Lake Cook Rd
Suite 101
Deerfield, IL 60015-4929
Phone (847) 940-9891

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
147-001042ILMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Audiology Associates of Deerfield, PC Audiologist CurrentSince Oct 24, 2015 Accepting new patients

Locations

400 Lake Cook Rd
Ste 101
Deerfield, IL 60015
Phone (847) 940-9880

400 Lake Cook Rd
Ste 106
Deerfield, IL 60015
Phone (847) 309-7393

Organizations & group practices 1

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": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397520000000",
    "number": "1710005699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 LAKE COOK RD",
            "address_2": "SUITE 106",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600155607",
            "telephone_number": "847-940-9891",
            "fax_number": "847-964-9343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 LAKE COOK RD",
            "address_2": "SUITE 106",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600155607",
            "telephone_number": "847-940-9891",
            "fax_number": "847-964-9343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTIAN",
        "first_name": "MARK",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2014-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IL",
            "license": "147-001042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deerfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2014; 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.