NPIMap

Organization Active NPI

PHC of Buffalo Grove Audiology

Doing business as Portrait Health Centers of Buffalo Grove Audiology

  • Audiologist-Hearing Aid Fitter
  • Buffalo Grove, IL
National Provider Identifier
1942501325
Registry record updated Nov 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
License
147-000978 Issued in IL
Legal business name
PHC OF BUFFALO GROVE AUDIOLOGY
Doing business as
Portrait Health Centers of Buffalo Grove Audiology
Practice address
150 W Half Day Rd
Suite 105
Buffalo Grove, IL 60089-6591
Phone
(847) 868-3435
Fax
(847) 859-5885
NPI assigned
Nov 16, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2010

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

Authorized official

Name
Dr. Michelle Melissa Mattingly, AUD, CCC-ANPI 1427364876
Title
President
Phone
(847) 868-3435

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid FitterGroup: 193400000X SINGLE SPECIALTY GROUP 237600000X 147-000978 IL Primary

Addresses

Primary practice location

150 W Half Day Rd
Suite 105
Buffalo Grove, IL 60089-6591

Mailing address

150 W Half Day Rd
Suite 105
Buffalo Grove, IL 60089-6591
Phone (847) 868-3435

Other names 1

  • Portrait Health Centers of Buffalo Grove Audiology Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1289865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289865600000",
    "number": "1942501325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 W HALF DAY RD",
            "address_2": "SUITE 105",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600896591",
            "telephone_number": "847-868-3435",
            "fax_number": "847-859-5885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 W HALF DAY RD",
            "address_2": "SUITE 105",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600896591",
            "telephone_number": "847-868-3435",
            "fax_number": "847-859-5885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHC OF BUFFALO GROVE AUDIOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-16",
        "last_updated": "2010-11-16",
        "status": "A",
        "authorized_official_last_name": "MATTINGLY",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "MELISSA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-868-3435",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "AUD, CCC-A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "IL",
            "license": "147-000978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Portrait Health Centers of Buffalo Grove Audiology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Buffalo Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2010; 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.