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NPI Code Detail

MEDICARE: SAMANTHA TREVINO HIS

MEDICARE: SAMANTHA TREVINO HIS
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
1237700000XHearing Instrument Specialist3567

General Provider Information

NPI Number : 1336959576
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA TREVINO HIS
Provider Business Mailing Address
First Line : 2142 W 21ST ST
Second Line :
City : CHICAGO
State : IL
Zip : 60608-2608
Country : US
Telephone Number : 773-733-9995
Fax Number :
Provider Business Practice Location Address
First Line : 9500 JOLIET RD
Second Line :
City : HODGKINS
State : IL
Zip : 60525-4137
Country : US
Telephone Number : 708-485-5226
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2025
Last Update Date : 01/09/2025

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Directions to “ SAMANTHA TREVINO HIS” Practice Location

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