Basic Information
| Provider Information | |||||||||
| NPI: | 1649527854 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MARX | ||||||||
| FirstName: | LAURA | ||||||||
| MiddleName: | BETH | ||||||||
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| Credential: | AU.D. | ||||||||
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| 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: | 5400 W ELM ST | ||||||||
| Address2: | STE 205 | ||||||||
| City: | MCHENRY | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600504010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8153446200 | ||||||||
| FaxNumber: | 8477418694 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/07/2012 | ||||||||
| LastUpdateDate: | 12/01/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/01/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | 147.001580 | IL | N | Speech, Language and Hearing Service Providers | Audiologist | 237600000X | 147.001580 | IL | N | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter | 237600000X | 706-156 | WI | N | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter | 237600000X | A.01813 | OH | N | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter | 231H00000X | 706-156 | WI | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.