Individual provider Active NPI

Mary Sue D. Heinzelmann, M.S., CCC-A

  • Audiologist-Hearing Aid Fitter
  • Woodstock, IL
National Provider Identifier
1891937223
Registry record updated Mar 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
License
147000457 Issued in IL
Practice address
1200 Claussen Dr
Woodstock, IL 60098-2139
Phone
(815) 337-2973
Fax
(815) 338-7550
NPI assigned
Mar 31, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X 147000457 IL Primary

Addresses

Primary practice location

1200 Claussen Dr
Woodstock, IL 60098-2139

Mailing address

1200 Claussen Dr
Woodstock, IL 60098-2139
Phone (815) 337-2973

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
147000457ILMDAudiologist-Hearing Aid Fitter

Practice roles

OrganizationSpecialtyStatusNew patients
Special Education District of McHenry County Past Accepting new patients
Special Ed District of McHenry County Past Accepting new patients

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": "1238457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238457600000",
    "number": "1891937223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CLAUSSEN DR",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600982139",
            "telephone_number": "815-337-2973",
            "fax_number": "815-338-7550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 CLAUSSEN DR",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600982139",
            "telephone_number": "815-337-2973",
            "fax_number": "815-338-7550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEINZELMANN",
        "first_name": "MARY SUE",
        "middle_name": "D.",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-31",
        "last_updated": "2009-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "IL",
            "license": "147000457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2009; 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.