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General NPI Number Information
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NPI Number | 1144436270
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Entity Type | Individual
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Provider Name | WYNNETTE J. MONEKA M.A.
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Gender | Female
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3860 W 95TH ST
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City | EVERGREEN PARK
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State | IL
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Zip | 60805-2034
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Country | US
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Telephone | 708-422-3500
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Fax | 708-422-3989
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Provider Business Mailing Address
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Address Line | 5536 VIRGINIA AVE
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City | CLARENDON HILLS
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State | IL
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Zip | 60514
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Country | US
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Telephone | 708-422-3500
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Fax | 708-422-3989
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State | IL
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