Healthcare Provider Details

I. General information

NPI: 1467786574
Provider Name (Legal Business Name): SOUND CHOICE HEARING CLINIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2009
Last Update Date: 09/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 N PARKWAY DR
PEKIN IL
61554-3932
US

IV. Provider business mailing address

117 N PARKWAY DR
PEKIN IL
61554-3932
US

V. Phone/Fax

Practice location:
  • Phone: 309-347-0500
  • Fax: 309-347-0501
Mailing address:
  • Phone: 309-347-0500
  • Fax: 309-347-0501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. DENISE M.J. COMERFORD
Title or Position: OWNER/DOCTOR OF AUDIOLOGY
Credential: AU.D.
Phone: 309-347-0500