MEDICARE: DR. RUDOLPH ALOYSIUS CHMELIK AU.D. CCC-A

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
1	231H00000X	Audiologist	7737	MN
2	231H00000X	Audiologist	A.01875	OH
3	231H00000X	Audiologist	23002674A	IN
4	231H00000X	Audiologist	2595	MN

General Provider Information

NPI Number	:	1215955315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RUDOLPH ALOYSIUS CHMELIK AU.D. CCC-A

Provider Business Mailing Address
First Line	:	3560 WATSON RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46205-3546
Country	:	US
Telephone Number	:	612-306-4164
Fax Number	:

Provider Business Practice Location Address
First Line	:	6920 PARKDALE PL STE 210
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46254-5611
Country	:	US
Telephone Number	:	866-284-8788
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	10/31/2025

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