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General NPI Number Information
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NPI Number | 1336874056
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Entity Type | Organization
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Legal Business Name | DUNCKLEY AUDIOLOGY
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Dates
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Enumeration Date | 07/18/2022
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Last Update Date | 09/22/2022
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Provider Practice Location Address
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Address Line | 1811 BENSON AVE
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City | EVANSTON
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State | IL
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Zip | 60201-3750
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Country | US
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Telephone | 847-453-3643
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Fax |
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Provider Business Mailing Address
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Address Line | 1811 BENSON AVE
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City | EVANSTON
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State | IL
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Zip | 60201-3750
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Country | US
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Telephone | 847-453-3643
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | KATHLEEN THERESA DUNCKLEY
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Credential | PH.D.
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Telephone | 872-230-1158
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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