Healthcare Provider Details

I. General information

NPI: 1770419392
Provider Name (Legal Business Name): MOLLY WHITCOMB AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4440 W 95TH ST RM 1337H
OAK LAWN IL
60453-2600
US

IV. Provider business mailing address

2444 EMERALD CT APT 102
WOODRIDGE IL
60517-3933
US

V. Phone/Fax

Practice location:
  • Phone: 708-684-4693
  • Fax: 708-520-1985
Mailing address:
  • Phone: 309-310-3210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number147-012361
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: