Healthcare Provider Details

I. General information

NPI: 1346028404
Provider Name (Legal Business Name): MLM USA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2023
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

462 ROOSEVELT RD
GLEN ELLYN IL
60137-5611
US

IV. Provider business mailing address

35 WATERVIEW BLVD STE 200
PARSIPPANY NJ
07054-7602
US

V. Phone/Fax

Practice location:
  • Phone: 630-469-6061
  • Fax:
Mailing address:
  • Phone: 973-794-6767
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State

VIII. Authorized Official

Name: MS. NICOLINDA PYRTKO
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 973-794-6767