Healthcare Provider Details
I. General information
NPI: 1346652195
Provider Name (Legal Business Name): CONNECT HEARING
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/28/2014
Last Update Date: 06/14/2023
Certification Date: 06/14/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5250 E US HIGHWAY 36 STE 155
AVON IN
46123-9199
US
IV. Provider business mailing address
750 N COMMONS DR STE 200
AURORA IL
60504-7940
US
V. Phone/Fax
- Phone: 317-745-7849
- Fax: 317-745-6112
- Phone: 630-303-5380
- Fax: 630-303-5385
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 231H00000X |
| Taxonomy | Audiologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 237600000X |
| Taxonomy | Audiologist-Hearing Aid Fitter |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 237700000X |
| Taxonomy | Hearing Instrument Specialist |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332S00000X |
| Taxonomy | Hearing Aid Equipment |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KEVIN
VESELY
Title or Position: VP OF FINANCE AND CONTROLLING
Credential:
Phone: 630-303-5380