=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528213204
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SOUND CARE HEARING CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/23/2008
-----------------------------------------------------
Last Update Date | 04/20/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 610 S MAPLE AVE SUITE 5300
-----------------------------------------------------
City | OAK PARK
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60304-1091
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 708-660-2350
-----------------------------------------------------
Fax | 708-660-2360
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 5141
-----------------------------------------------------
City | RIVER FOREST
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60305-5141
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 708-660-2350
-----------------------------------------------------
Fax | 708-660-2360
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO/PRESIDENT
-----------------------------------------------------
Name | DR. REBECCA LYNNE ANDERSON
-----------------------------------------------------
Credential | AU.D.
-----------------------------------------------------
Telephone | 708-660-2350
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 231H00000X
-----------------------------------------------------
Taxonomy Name | Audiologist
-----------------------------------------------------
License Number | 147-000851
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------