NPIMap

Organization Active NPI

Tri-County Hearing

Doing business as Avada Audiology & Hearing Care

  • Audiologist
  • Oak Lawn, IL
National Provider Identifier
1801000658
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
2676 Issued in IL
Legal business name
TRI-COUNTY HEARING
Doing business as
Avada Audiology & Hearing Care
Practice address
4237 W 95TH St
Oak Lawn, IL 60453-2623
Phone
(708) 636-7500
Fax
(708) 636-7652
NPI assigned
May 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Jaclyn Sullivan
Title
Office Manager
Phone
(708) 636-7500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AudiologistGroup: 193400000X SINGLE SPECIALTY GROUP 231H00000X 2676 IL Primary

Addresses

Primary practice location

4237 W 95TH St
Oak Lawn, IL 60453-2623

Mailing address

140 Corporate Dr.
Suite 1
Beaver Dam, WI 53916
Phone (920) 887-2822

Other identifiers 1

IdentifierTypeStateIssuer
0001620840OtherILBLUE CROSS BLUE SHIELD

Other names 1

  • Avada Audiology & Hearing Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Avada Audiology Hearing Care5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801000658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 CORPORATE DR.",
            "address_2": "SUITE 1",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "53916",
            "telephone_number": "920-887-2822",
            "fax_number": "920-887-9655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4237 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532623",
            "telephone_number": "708-636-7500",
            "fax_number": "708-636-7652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-COUNTY HEARING",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "JACLYN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "708-636-7500"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Audiologist",
            "state": "IL",
            "license": "2676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0001620840",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avada Audiology & Hearing Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oak Lawn, IL

Sources for this page

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

Verify at the official NPI Registry.