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General NPI Number Information
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NPI Number | 1730329426
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Entity Type | Organization
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Legal Business Name | WESTERN ILLINOIS UNIVERSITY SPEECH LANGUAGE HEARING CLINIC
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Dates
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Enumeration Date | 02/20/2009
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Last Update Date | 02/20/2009
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Provider Practice Location Address
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Address Line | 1 UNIVERSITY CIR 125 CURRENS HALL
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City | MACOMB
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State | IL
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Zip | 61455-1367
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Country | US
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Telephone | 309-298-1955
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Fax | 309-298-2049
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Provider Business Mailing Address
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Address Line | 1 UNIVERSITY CIR 125 CURRENS HALL
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City | MACOMB
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State | IL
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Zip | 61455-1367
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Country | US
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Telephone | 309-298-1955
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Fax | 309-298-2049
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Authorized Official
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Title or Position | AUDIOLOGY CLINIC COORDINATOR
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Name | PROF. AMANDA BETH SILBERER
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Credential | AU.D., CCC/A
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Telephone | 309-298-1955
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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 | 147001084
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | 14700928
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License Number State | IL
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