Healthcare Provider Details

I. General information

NPI: 1629321989
Provider Name (Legal Business Name): KELLY SUZANNE GASPAROVICH AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KELLY SUZANNE DVORAK

II. Dates (important events)

Enumeration Date: 10/23/2012
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2040 OGDEN AVE STE 401
AURORA IL
60504-7208
US

IV. Provider business mailing address

2000 OGDEN AVE STE P050
AURORA IL
60504-7222
US

V. Phone/Fax

Practice location:
  • Phone: 630-978-6895
  • Fax: 630-375-2905
Mailing address:
  • Phone: 630-499-2404
  • Fax: 630-499-4750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number147001438
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number147001438
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: