Healthcare Provider Details

I. General information

NPI: 1417753724
Provider Name (Legal Business Name): AUDITORY THERAPY FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2025
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 TOWER DR STE 101
BURR RIDGE IL
60527-5778
US

IV. Provider business mailing address

1900 AVENIDA HIGH VW
DRIFTWOOD TX
78619-8900
US

V. Phone/Fax

Practice location:
  • Phone: 630-740-9330
  • Fax: 630-654-9214
Mailing address:
  • Phone: 630-740-9330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. RICHARD UZUANIS
Title or Position: EXECUTIVE DIRECTOR
Credential: MBA
Phone: 630-740-9330