Physician Compare National (NPI:1770714636)

HEALTHCARE PROVIDER: MARIE ROSE VETTER AU.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1770714636
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2567645815
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110323000613
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	VETTER
	Individual professional last name
Provider First Name	MARIE
	Individual professional first name
Provider Middle Name	R
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2009
	Individual professional's medical school graduation year
Primary Specialty	QUALIFIED AUDIOLOGIST
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	5600 W ADDISON ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 502
	Group Practice or individual's line 2 address
City	CHICAGO
	Group Practice or individual's city
State	IL
	Group Practice or individual's state
Zip Code	606344466
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y