Healthcare Provider Details

I. General information

NPI: 1366918864
Provider Name (Legal Business Name): ANN GEAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2018
Last Update Date: 10/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18160 W GAGES LAKE RD
GAGES LAKE IL
60030-1819
US

IV. Provider business mailing address

18160 W GAGES LAKE RD
GAGES LAKE IL
60030-1819
US

V. Phone/Fax

Practice location:
  • Phone: 847-986-2343
  • Fax:
Mailing address:
  • Phone: 847-986-2343
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number147000319
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: