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General NPI Number Information
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NPI Number | 1316101702
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Entity Type | Individual
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Provider Name | MAGDALENE MARIE BOORAZANES AU.D
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Gender | Female
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Dates
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Enumeration Date | 07/15/2008
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Last Update Date | 08/21/2013
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Provider Practice Location Address
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Address Line | 1855 W TAYLOR ST DIVISION OF AUDIOLOGY (MC 648)
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City | CHICAGO
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State | IL
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Zip | 60612-7242
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Country | US
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Telephone | 312-996-6522
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Fax |
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Provider Business Mailing Address
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Address Line | 1855 WEST TAYLOR STREET, B.76 EEI DIVISION OF AUDIOLOGY (MC 648)
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City | CHICAGO
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State | IL
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Zip | 60612
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Country | US
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Telephone | 312-996-6522
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Fax |
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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 | 147.001284
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | 147.001284
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License Number State | IL
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