Audiology Associates of Deerfield, PC
Organization Active NPI Audiologist · Deerfield, IL
NPI 1992993687 · NPPES record last updated Oct 9, 2007
Key facts
- NPI
- 1992993687
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Audiologist 231H00000X
- Legal business name
- AUDIOLOGY ASSOCIATES OF DEERFIELD, PC
- Practice address
- 400 Lake Cook Rd
Suite 108
Deerfield, IL 60015-5607 - Phone
- (847) 940-9891
- NPI assigned
- Oct 9, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Sheri Gostomelsky, AU.D.
- Title
- Doctor of Audiology/Owner
- Phone
- (847) 940-9891
Practitioners 2
-
Sheri Gostomelsky, AU.D.
-
Mark Scott Christian, AU.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071109000382 | IL | Part B Supplier - Clinic/Group Practice | 6204924194 |
Receives reassigned benefits from 2 practitioners Practice locations: Deerfield, IL |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist |
231H00000X | IL | Yes |
Addresses
Primary practice location
400 Lake Cook Rd
Suite 108
Deerfield, IL 60015-5607
Mailing address
400 Lake Cook Rd
Suite 108
Deerfield, IL 60015-5607
Phone (847) 940-9891
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04927037 | Other | IL | BLUE CROSS BLUE SHIELD |
Other providers in Deerfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.