Individual provider Active NPI

Genevieve Malcolm

  • Audiologist
  • Naperville, IL
National Provider Identifier
1801067061
Registry record updated Aug 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
147001298 Issued in IL
Practice address
1308 Macom Dr Ste 103
Naperville, IL 60564-9256
Phone
(630) 848-9665
Fax
(630) 904-4373
NPI assigned
Mar 17, 2008
Last updated
Aug 27, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 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 147001298 IL Primary

Addresses

Primary practice location

1308 Macom Dr Ste 103
Naperville, IL 60564-9256

Mailing address

1308 Macom Dr Ste 103
Naperville, IL 60564-9256
Phone (630) 904-4327

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090312000588 IL Practitioner - Qualified Audiologist 9436226800 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1308 Macom Dr
Suite 103
Naperville, IL 60564-9256
Phone (630) 848-9665

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
147001298ILMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Auditory Processing Current Accepting new patients
Hear Audiology LLC Audiologist CurrentSince Nov 5, 2015 Accepting new patients
ENT Specialists, P.C. PastSince Jul 1, 2007 Accepting new patients
Affordable Hearing Solutions Audiologist Past Accepting new patients
Lester and Rosalie Anixter Center Audiologist PastSince Nov 16, 2009 Accepting new patients

Locations

1308 Macom Dr
Ste 103
Naperville, IL 60564
Phone (630) 585-0800

1935 Springbrook Square Dr
Ste 109
Naperville, IL 60564
Phone (630) 904-4237

Organizations & group practices 5

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": "1205712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630022400000",
    "number": "1801067061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1308 MACOM DR STE 103",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605649256",
            "telephone_number": "630-904-4327",
            "fax_number": "630-904-4373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1308 MACOM DR STE 103",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605649256",
            "telephone_number": "630-848-9665",
            "fax_number": "630-904-4373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALCOLM",
        "first_name": "GENEVIEVE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-17",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IL",
            "license": "147001298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.