Basic Information
| Provider Information | |||||||||
| NPI: | 1497904213 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LANEY | ||||||||
| FirstName: | ANN | ||||||||
| MiddleName: | THERESE | ||||||||
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| Credential: | AUDIOLOGIST | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2900 FRANK SCOTT PKWY W | ||||||||
| Address2: | SUITE 930 | ||||||||
| City: | BELLEVILLE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 622235000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6182358080 | ||||||||
| FaxNumber: | 6182357795 | ||||||||
| Practice Location | |||||||||
| Address1: | 2900 FRANK SCOTT PKWY W | ||||||||
| Address2: | SUITE 930 | ||||||||
| City: | BELLEVILLE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 622235000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6182358080 | ||||||||
| FaxNumber: | 6182357795 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/17/2008 | ||||||||
| LastUpdateDate: | 03/20/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | 147.000405 | IL | Y | Speech, Language and Hearing Service Providers | Audiologist | 237600000X | 147.000405 | IL | N | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter |
No ID Information.