Individual provider Active NPI

Tracy Hagan Winn, AU.D.

  • Audiologist
  • Evanston, IL
National Provider Identifier
1982726899
Registry record updated Oct 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
147000871 Issued in IL
Practice address
2240 Campus Dr
Evanston, IL 60208-0895
Phone
(847) 491-3165
Fax
(847) 467-0410
NPI assigned
Apr 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 147000871 IL Primary

Addresses

Primary practice location

2240 Campus Dr
Evanston, IL 60208-0895

Mailing address

2315 Campus Dr
Evanston, IL 60208-0895
Phone (847) 491-3165

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040819000447 IL Practitioner - Qualified Audiologist 1557334281 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
147000871ILMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Nov 1, 2019 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Nov 1, 2019 Accepting new patients
Aggeus Healthcare, P.C. Past Accepting new patients
Northwestern University Audiology Clinic Audiologist Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

2315 Campus Dr
Evanston, IL 60208
Phone (847) 467-1198

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Organizations & group practices 4

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": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571184000000",
    "number": "1982726899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 CAMPUS DR",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602080895",
            "telephone_number": "847-491-3165",
            "fax_number": "847-467-7141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 CAMPUS DR",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602080895",
            "telephone_number": "847-491-3165",
            "fax_number": "847-467-0410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINN",
        "first_name": "TRACY",
        "middle_name": "HAGAN",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2019-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IL",
            "license": "147000871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.