Individual provider Active NPI

Elizabeth Therese Fetscher, AU.D.

  • Audiologist
  • Gurnee, IL
National Provider Identifier
1790448694
Registry record updated Oct 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
147.001826 Issued in IL
Practice address
35 Tower CT
Gurnee, IL 60031-5712
Phone
(847) 453-3832
NPI assigned
Oct 18, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 147.001826 IL Primary

Addresses

Primary practice location

35 Tower CT
Gurnee, IL 60031-5712

Mailing address

285 N Illinois St
Elmhurst, IL 60126-2448
Phone (630) 632-0630

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211102001525 IL Practitioner - Qualified Audiologist 8426446956 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Illinois Medical College, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hearing Associates IncGroup PAC ID 3971740903, 4 clinicians

Practice addresses (Care Compare)

755 S Milwaukee Ave
Suite 101
Libertyville, IL 60048-3267
Phone (847) 680-7580

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
147.001826ILMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Hearing Associates, Inc Audiologist CurrentSince Oct 26, 2021 Accepting new patients
Hearing Associates PC Audiologist PastSince Oct 24, 2021 Accepting new patients

Locations

35 Tower Ct
Ste A
Gurnee, IL 60031
Phone (847) 662-9300

755 S Milwaukee Ave
Ste 189
Libertyville, IL 60048
Phone (847) 680-7580

755 S Milwaukee Ave
Ste 101
Libertyville, IL 60048
Phone (847) 570-2860

755 S Milwaukee Ave
Libertyville, IL 60048
Phone (847) 680-7002

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1634515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634515200000",
    "number": "1790448694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 N ILLINOIS ST",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601262448",
            "telephone_number": "630-632-0630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 TOWER CT",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600315712",
            "telephone_number": "847-453-3832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETSCHER",
        "first_name": "ELIZABETH",
        "middle_name": "THERESE",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-18",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IL",
            "license": "147.001826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gurnee, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2021; 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.