Active NPI
Juan Elias Vasquez, AUD
- Audiologist
- Chicago, IL
National Provider Identifier
1730719337
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 147.001756
- Practice address
- 920 W Cullom Ave PH Unit
Chicago, IL 60613-1632 - Phone
- (909) 992-9660
- NPI assigned
- Jan 22, 2020
- Sex
- Male
- 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 | 147.001756 | IL | Primary |
Addresses
Primary practice location
920 W Cullom Ave PH Unit
Chicago, IL 60613-1632
Mailing address
920 W Cullom Ave PH Unit
Chicago, IL 60613-1632
Phone (909) 992-9660
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 147.001756 | IL | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1579651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579651200000",
"number": "1730719337",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "920 W CULLOM AVE PH UNIT",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606131632",
"telephone_number": "909-992-9660"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 W CULLOM AVE PH UNIT",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606131632",
"telephone_number": "909-992-9660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VASQUEZ",
"first_name": "JUAN",
"middle_name": "ELIAS",
"credential": "AUD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-01-22",
"last_updated": "2020-01-22",
"certification_date": "2020-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "IL",
"license": "147.001756",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 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.