Healthcare Provider Details

I. General information

NPI: 1205876604
Provider Name (Legal Business Name): JULIE ANN PATTON AU.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIE ANN SEBILLE

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 05/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 E STRONG ST SUITE 4
WHEELING IL
60090-2979
US

IV. Provider business mailing address

201 E STRONG ST SUITE 4
WHEELING IL
60090-2979
US

V. Phone/Fax

Practice location:
  • Phone: 847-353-8802
  • Fax: 847-353-8812
Mailing address:
  • Phone: 847-353-8802
  • Fax: 847-353-8812

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number147000908
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: