MEDICARE: DR. MARY COLLEEN CONROY AU.D.

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	147001062	IL

General Provider Information

NPI Number	:	1467520874
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY COLLEEN CONROY AU.D.

Provider Business Mailing Address
First Line	:	9071 SOUTH 1300 WEST
Second Line	:	SUITE 100
City	:	WEST JORDAN
State	:	UT
Zip	:	84088
Country	:	US
Telephone Number	:	801-938-1117
Fax Number	:	801-938-2771

Provider Business Practice Location Address
First Line	:	27475 FERRY ROAD
Second Line	:	#109
City	:	WARRENVILLE
State	:	IL
Zip	:	60555-3808
Country	:	US
Telephone Number	:	630-717-2751
Fax Number	:	866-961-3161

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

Provider Enumeration Date	:	12/01/2006
Last Update Date	:	04/28/2011

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