Healthcare Provider Details
I. General information
NPI: 1083174569
Provider Name (Legal Business Name): NORTHLAND HEARING CENTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/21/2019
Last Update Date: 05/08/2024
Certification Date: 05/08/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
530 N HOUGH ST STE 120
BARRINGTON IL
60010-3176
US
IV. Provider business mailing address
6700 WASHINGTON AVE S
EDEN PRAIRIE MN
55344-3405
US
V. Phone/Fax
- Phone: 847-842-8110
- Fax:
- Phone: 800-328-8602
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QH0700X |
| Taxonomy | Hearing and Speech Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BEE
XIONG
Title or Position: MANAGER OF REVENUE CYCLE
Credential:
Phone: 952-995-6601