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NPI Code Detail

MEDICARE: JAIN AUDIOLOGY SPECIALISTS, P.C.

MEDICARE: JAIN AUDIOLOGY SPECIALISTS, P.C.
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
1332B00000XDurable Medical Equipment & Medical Supplies147001053IL

General Provider Information

NPI Number : 1366671984
Entity Type Code : Organization
Provider Name (Legal Business Name) : JAIN AUDIOLOGY SPECIALISTS, P.C.
Provider Business Mailing Address
First Line : 3213 N ROCKWELL ST
Second Line :
City : CHICAGO
State : IL
Zip : 60618-5934
Country : US
Telephone Number : 847-452-9659
Fax Number :
Provider Business Practice Location Address
First Line : 712 N DEARBORN ST
Second Line :
City : CHICAGO
State : IL
Zip : 60654-3818
Country : US
Telephone Number : 847-452-9659
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. LATA JAIN
Credential : AUD
Telephone Number : 847-452-9659
Provider Enumeration Date : 07/02/2009
Last Update Date : 07/02/2009

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