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General NPI Number Information
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NPI Number | 1366601445
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Entity Type | Organization
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Legal Business Name | MAS AUDIOLOGY, LLC
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Dates
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Enumeration Date | 06/04/2008
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Last Update Date | 06/04/2008
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Provider Practice Location Address
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Address Line | 962 N NORTHWEST HWY
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City | PARK RIDGE
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State | IL
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Zip | 60068-2358
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Country | US
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Telephone | 847-939-6053
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Fax | 847-939-6071
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Provider Business Mailing Address
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Address Line | 962 N NORTHWEST HWY
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City | PARK RIDGE
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State | IL
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Zip | 60068-2358
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Country | US
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Telephone | 847-939-6053
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Fax | 847-939-6071
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Authorized Official
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Title or Position | CEO
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Name | MR. SARGON KHAMO
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Credential |
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Telephone | 847-939-6053
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number |
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License Number State |
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