Healthcare Provider Details
I. General information
NPI: 1346068152
Provider Name (Legal Business Name): SOUTHWEST HEARING SOLUTIONS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/30/2024
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1802 N DIVISION ST STE 218
MORRIS IL
60450-3107
US
IV. Provider business mailing address
1802 N DIVISION ST STE 218
MORRIS IL
60450-3107
US
V. Phone/Fax
- Phone: 815-846-7180
- Fax: 815-846-7118
- Phone: 815-846-7180
- Fax: 815-846-7118
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 231H00000X |
| Taxonomy | Audiologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QH0700X |
| Taxonomy | Hearing and Speech Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332S00000X |
| Taxonomy | Hearing Aid Equipment |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JAMIE
ELLEN
SIKORA
Title or Position: AUDIOLOGIST/OWNER
Credential: AU.D.
Phone: 815-666-4478