Healthcare Provider Details

I. General information

NPI: 1033972849
Provider Name (Legal Business Name): MIDWEST AUDIOLOGY SPECIALISTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2024
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

585 W CHERRY ST STE A
NORTH LIBERTY IA
52317-9797
US

IV. Provider business mailing address

585 W CHERRY ST STE A
NORTH LIBERTY IA
52317-9849
US

V. Phone/Fax

Practice location:
  • Phone: 319-249-6925
  • Fax: 319-205-0625
Mailing address:
  • Phone: 319-365-0005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TANYA VAN VOORST
Title or Position: AUDIOLOGIST/OWNER
Credential:
Phone: 319-270-8229