MEDICARE: DANE LEAVITT

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	231H00000X	Audiologist	81680	TX
2	237600000X	Audiologist-Hearing Aid Fitter	81680	TX

General Provider Information

NPI Number	:	1285419127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANE LEAVITT

Provider Business Mailing Address
First Line	:	750 N COMMONS DR STE 200
Second Line	:
City	:	AURORA
State	:	IL
Zip	:	60504-7940
Country	:	US
Telephone Number	:	630-303-5380
Fax Number	:	630-303-5385

Provider Business Practice Location Address
First Line	:	6991 MEDITERRANEAN DR
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75072-5536
Country	:	US
Telephone Number	:	972-542-8900
Fax Number	:	972-542-8944

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

Provider Enumeration Date	:	08/29/2023
Last Update Date	:	08/29/2023

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Directions to “ DANE LEAVITT ” Practice Location

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