Basic Information
| Provider Information | |||||||||
| NPI: | 1396152112 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HEARUSA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1421 E HARRISON AVE | ||||||||
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| City: | WHEATON | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601874423 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6302346847 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8 S MICHIGAN AVE | ||||||||
| Address2: | SUITE 2212 | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60603 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3123461136 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/14/2014 | ||||||||
| LastUpdateDate: | 07/14/2014 | ||||||||
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| AuthorizedOfficialLastName: | KIMBLE | ||||||||
| AuthorizedOfficialFirstName: | JACKIE | ||||||||
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| AuthorizedOfficialTitleorPosition: | HUMAN RESOURCES | ||||||||
| AuthorizedOfficialTelephone: | 5614788770 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | AUDIOLOGY DISTRIBUTION LCC DBA | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | 147001511 | IN | Y | 193200000X MULTI-SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.