Healthcare Provider Details

I. General information

NPI: 1457680985
Provider Name (Legal Business Name): YVONNE M FEFFER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2009
Last Update Date: 04/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 N WABASH AVE STE 1618
CHICAGO IL
60602-3049
US

IV. Provider business mailing address

215 SHUMAN BLVD STE 401
NAPERVILLE IL
60563-8123
US

V. Phone/Fax

Practice location:
  • Phone: 312-251-0100
  • Fax: 312-251-0123
Mailing address:
  • Phone: 630-303-5380
  • Fax: 630-303-5385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number147.001327
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: