Basic Information
| Provider Information | |||||||||
| NPI: | 1205876604 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PATTON | ||||||||
| FirstName: | JULIE | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | AU.D | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | SEBILLE | ||||||||
| OtherFirstName: | JULIE | ||||||||
| OtherMiddleName: | ANN | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 201 E STRONG ST | ||||||||
| Address2: | SUITE 4 | ||||||||
| City: | WHEELING | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600902979 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8473538802 | ||||||||
| FaxNumber: | 8473538812 | ||||||||
| Practice Location | |||||||||
| Address1: | 201 E STRONG ST | ||||||||
| Address2: | SUITE 4 | ||||||||
| City: | WHEELING | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600902979 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8473538802 | ||||||||
| FaxNumber: | 8473538812 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/07/2006 | ||||||||
| LastUpdateDate: | 05/11/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237600000X | 147000908 | IL | Y | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter |
No ID Information.