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NPI Code Detail

MEDICARE: AUDIO ADVANTAGE AIDS

MEDICARE: AUDIO ADVANTAGE AIDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QH0700XHearing and Speech Clinic/Center0372295IL
2332S00000XHearing Aid Equipment0372295IL

General Provider Information

NPI Number : 1023344207
Entity Type Code : Organization
Provider Name (Legal Business Name) : AUDIO ADVANTAGE AIDS
Provider Business Mailing Address
First Line : 4210 W MONTROSE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60641-2002
Country : US
Telephone Number : 773-348-8760
Fax Number :
Provider Business Practice Location Address
First Line : 4210 W MONTROSE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60641-2002
Country : US
Telephone Number : 773-348-8760
Fax Number :
Authorized Official
Title or Position : OWNER, H.I.S.
Name : MS. JEANETTE R HUPP
Credential : H.I.S.
Telephone Number : 773-348-8760
Provider Enumeration Date : 10/23/2009
Last Update Date : 10/07/2014

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