Basic Information
Provider Information
NPI: 1548582612
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LITTLEPAGE
FirstName: DAVID
MiddleName: M
NamePrefix:  
NameSuffix:  
Credential:  
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: 1719 S LOOP 288 STE 165
Address2:  
City: DENTON
State: TX
PostalCode: 762054815
CountryCode: US
TelephoneNumber: 9405662425
FaxNumber: 9405662469
Other Information
ProviderEnumerationDate: 02/17/2010
LastUpdateDate: 07/06/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/06/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
237700000X80385TXY Speech, Language and Hearing Service ProvidersHearing Instrument Specialist 

No ID Information.


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