Healthcare Provider Details

I. General information

NPI: 1396265849
Provider Name (Legal Business Name): LOU ECHOLS CHAMBERS MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2017
Last Update Date: 06/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 SOUTH SIXTH STREET
CHAMAPIGN IL
61820
US

IV. Provider business mailing address

901 S 6TH ST
CHAMPAIGN IL
61820-6206
US

V. Phone/Fax

Practice location:
  • Phone: 217-333-2230
  • Fax: 217-244-2235
Mailing address:
  • Phone: 217-333-2230
  • Fax: 217-244-2235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number147000339
License Number StateIL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: