Kendra Lenee Theodosopoulos, AU.D.

Primary specialty

AudiologistTaxonomy code 231H00000X

License

147001591 Issued in IL

Practice address

2200 Marquette Rd Ste 115
Peru, IL 61354-1587

Phone

(815) 223-1100

Fax

(815) 223-4105

NPI assigned

Mar 10, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Qualified Audiologist

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Theos Audiology Solutions LLC

  • Hearing and Speech Clinic/Center
  • Peru, IL
  • NPI 1740762269
  Medicare reassignment NPD Authorized official
• Connect Hearing, Inc.

  • Hearing Aid Equipment
  • Elgin, IL
  • NPI 1760735435

  Audiologist

  NPD (past)
• The Hearing Clinic

  • Audiologist
  • Galesburg, IL
  • NPI 1780868307
  NPD (past)

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

{
    "created_epoch": "1457568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550102400000",
    "number": "1912368416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 MARQUETTE RD STE 115",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613541587",
            "telephone_number": "815-223-1100",
            "fax_number": "630-303-5385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 MARQUETTE RD STE 115",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613541587",
            "telephone_number": "815-223-1100",
            "fax_number": "815-223-4105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEODOSOPOULOS",
        "first_name": "KENDRA",
        "middle_name": "LENEE",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-10",
        "last_updated": "2019-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IL",
            "license": "147001591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St. Margaret'S Health-Peru
• St. Margaret'S Health-Peru
• Scott Richard Stanke, DDS
• Donna J. Sweetland, M.D.
• The Visions Group, Inc.
• Theos Audiology Solutions LLC
• Kory David Tieman, PT, DPT
• Timothy J Mertes and Michael D Piller Partners
• Mary Claire Tomminello
• Tricia Tonarelli

• Audiologist in Peru, IL
• Providers in Peru, IL by specialty
• Audiologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2019; 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.