Basic Information
Provider Information
NPI: 1982957981
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOBLER
FirstName: JUSTIN
MiddleName: L
NamePrefix:  
NameSuffix:  
Credential: H.I.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6700 WASHINGTON AVE S
Address2:  
City: EDEN PRAIRIE
State: MN
PostalCode: 553443405
CountryCode: US
TelephoneNumber: 6123511529
FaxNumber:  
Practice Location
Address1: 1832 S ARLINGTON HEIGHTS RD
Address2:  
City: ARLINGTON HEIGHTS
State: IL
PostalCode: 600053764
CountryCode: US
TelephoneNumber: 8473788456
FaxNumber: 8476212384
Other Information
ProviderEnumerationDate: 10/16/2012
LastUpdateDate: 08/01/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
237600000X3042ILN Speech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter 
237700000X3042ILY Speech, Language and Hearing Service ProvidersHearing Instrument Specialist 

No ID Information.


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