MEDICARE: KORY ROGERS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	237700000X	Hearing Instrument Specialist	80611	TX

General Provider Information

NPI Number	:	1255887840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KORY ROGERS

Provider Business Mailing Address
First Line	:	215 SHUMAN BLVD STE 401
Second Line	:
City	:	NAPERVILLE
State	:	IL
Zip	:	60563-8123
Country	:	US
Telephone Number	:	630-303-5380
Fax Number	:	630-303-5385

Provider Business Practice Location Address
First Line	:	5512 BELLAIRE DR S STE K
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76109-5800
Country	:	US
Telephone Number	:	817-546-0514
Fax Number	:	817-546-0518

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/01/2016
Last Update Date	:	03/27/2018

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Directions to “ KORY ROGERS ” Practice Location

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