MEDICARE: A-1 HEARING AID CENTER, INC.

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	332S00000X	Hearing Aid Equipment	1330895	IL

General Provider Information

NPI Number	:	1316110158
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A-1 HEARING AID CENTER, INC.

Provider Business Mailing Address
First Line	:	1627 W BELMONT AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-3017
Country	:	US
Telephone Number	:	773-477-1069
Fax Number	:	773-477-3462

Provider Business Practice Location Address
First Line	:	1627 W BELMONT AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-3017
Country	:	US
Telephone Number	:	773-477-1069
Fax Number	:	773-477-3462

Authorized Official
Title or Position	:	OWNER
Name	:	MR. SARGISS KHOSHABA
Credential	:
Telephone Number	:	773-477-1069

Provider Enumeration Date	:	04/11/2008
Last Update Date	:	04/11/2008

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