Basic Information
Provider Information | |||||||||
NPI: | 1477157568 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | HEBB | ||||||||
FirstName: | MEGAN | ||||||||
MiddleName: | M | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | AUD | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 750 N COMMONS DR STE 200 | ||||||||
Address2: |   | ||||||||
City: | AURORA | ||||||||
State: | IL | ||||||||
PostalCode: | 605047940 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 6303035380 | ||||||||
FaxNumber: | 6303035385 | ||||||||
Practice Location | |||||||||
Address1: | 111 N WABASH AVE STE 1618 | ||||||||
Address2: |   | ||||||||
City: | CHICAGO | ||||||||
State: | IL | ||||||||
PostalCode: | 606023049 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3122510100 | ||||||||
FaxNumber: | 3122510123 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 11/30/2020 | ||||||||
LastUpdateDate: | 11/30/2020 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 08/12/2020 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237600000X | 147001788 | IL | N |   | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter |   | 231H00000X | 147001788 | IL | Y |   | Speech, Language and Hearing Service Providers | Audiologist |   |
No ID Information.