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General NPI Number Information
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NPI Number | 1679704639
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Entity Type | Individual
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Provider Name | THERESA TRIMARCO AU.D.
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Gender | Female
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Dates
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Enumeration Date | 08/06/2009
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Last Update Date | 06/10/2011
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Provider Practice Location Address
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Address Line | 610 S MAPLE AVE 5300
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City | OAK PARK
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State | IL
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Zip | 60304-1091
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Country | US
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Telephone | 708-660-2350
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Fax | 708-660-2360
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Provider Business Mailing Address
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Address Line | 1550 SANDHURST CT UNIT C
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City | WHEATON
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State | IL
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Zip | 60189-2704
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Country | US
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Telephone |
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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 | 147001316
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License Number State | IL
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