=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699931519
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DOUGLAS WILLIAM BENTHIEN M.S.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/30/2008
-----------------------------------------------------
Last Update Date | 10/28/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | N81W15000 APPLETON AVE
-----------------------------------------------------
City | MENOMONEE FALLS
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53051-3839
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 262-764-4290
-----------------------------------------------------
Fax | 262-350-7020
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 750 N COMMONS DR STE 200
-----------------------------------------------------
City | AURORA
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60504-8025
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-303-5380
-----------------------------------------------------
Fax | 630-303-5385
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 237600000X
-----------------------------------------------------
Taxonomy Name | Audiologist-Hearing Aid Fitter
-----------------------------------------------------
License Number | 311-156
-----------------------------------------------------
License Number State | WI
-----------------------------------------------------