Basic Information
Provider Information
NPI: 1316340391
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CUMMINS
FirstName: JOHN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 750 N COMMONS DR STE 400
Address2:  
City: AURORA
State: IL
PostalCode: 605047940
CountryCode: US
TelephoneNumber: 6303035380
FaxNumber: 6303035385
Practice Location
Address1: 410 MEADOW CREEK DR STE 1.107
Address2:  
City: WESTMINSTER
State: MD
PostalCode: 211589426
CountryCode: US
TelephoneNumber: 4108761200
FaxNumber: 4108484916
Other Information
ProviderEnumerationDate: 10/03/2014
LastUpdateDate: 02/18/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/18/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
237700000X  Y Speech, Language and Hearing Service ProvidersHearing Instrument Specialist 

No ID Information.


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