Healthcare Provider Details
I. General information
NPI: 1982295804
Provider Name (Legal Business Name): HEARING AND BALANCE SPECIALISTS OF ILLINOIS LLC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/02/2021
Last Update Date: 06/13/2025
Certification Date: 06/13/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
21124 WASHINGTON PKWY
FRANKFORT IL
60423-3112
US
IV. Provider business mailing address
21124 WASHINGTON PKWY
FRANKFORT IL
60423-3112
US
V. Phone/Fax
- Phone: 815-239-0673
- Fax: 815-412-2985
- Phone: 815-239-0673
- Fax: 815-412-2985
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 231H00000X |
| Taxonomy | Audiologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
SCOTT
SUMRALL
Title or Position: AUDIOLOGIST/OWNER
Credential: AU.D.
Phone: 815-239-0673