Healthcare Provider Details

I. General information

NPI: 1861428203
Provider Name (Legal Business Name): ADELE M. OLMETTI M.A. CCC-A FAAA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 09/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9669 KENTON AVE STE 605
SKOKIE IL
60076-1248
US

IV. Provider business mailing address

9669 KENTON AVE STE 605
SKOKIE IL
60076-1248
US

V. Phone/Fax

Practice location:
  • Phone: 847-674-3626
  • Fax: 847-674-5250
Mailing address:
  • Phone: 847-674-3626
  • Fax: 847-674-5250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number147-000965
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: