Healthcare Provider Details

I. General information

NPI: 1881117455
Provider Name (Legal Business Name): JESSICA PEARL TOBOIKA AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2017
Last Update Date: 07/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 E HARVARD AVE STE 620
DENVER CO
80210-7002
US

IV. Provider business mailing address

215 SHUMAN BLVD STE 401
NAPERVILLE IL
60563-8123
US

V. Phone/Fax

Practice location:
  • Phone: 303-722-0886
  • Fax: 303-722-0918
Mailing address:
  • Phone: 630-303-5380
  • Fax: 630-303-5385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAUD.0000862
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: