Healthcare Provider Details

I. General information

NPI: 1720522923
Provider Name (Legal Business Name): JULES A. KIEFER JR. M.S.,CCC-A
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2016
Last Update Date: 03/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 PANTHER LN
NAPLES FL
34109-7874
US

IV. Provider business mailing address

215 SHUMAN BLVD STE 401
NAPERVILLE IL
60563-8123
US

V. Phone/Fax

Practice location:
  • Phone: 239-591-6604
  • Fax: 239-591-6605
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 NumberAY570
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: