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General NPI Number Information
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NPI Number | 1790671428
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Entity Type | Individual
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Provider Name | KRISTA LEA IRMEGER AUD
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Gender | Female
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Dates
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Enumeration Date | 06/17/2025
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 698 FEATHERSTONE RD STE 125
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City | ROCKFORD
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State | IL
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Zip | 61107-6303
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Country | US
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Telephone | 815-398-3277
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Fax |
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Provider Business Mailing Address
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Address Line | 7904 WELDON WOODS CLOSE
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City | ROCKFORD
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State | IL
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Zip | 61102-5621
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Country | US
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Telephone | 815-262-5216
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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 | 147.002057
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License Number State | IL
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