MEDICARE: HEARING CARE OF PALATINE, 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	231H00000X	Audiologist	147-000541	IL

General Provider Information

NPI Number	:	1760652101
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEARING CARE OF PALATINE, INC.

Provider Business Mailing Address
First Line	:	305 E NORTHWEST HWY
Second Line	:
City	:	PALATINE
State	:	IL
Zip	:	60067-8116
Country	:	US
Telephone Number	:	847-358-2896
Fax Number	:	847-358-5896

Provider Business Practice Location Address
First Line	:	305 E NORTHWEST HWY
Second Line	:
City	:	PALATINE
State	:	IL
Zip	:	60067-8116
Country	:	US
Telephone Number	:	847-358-2896
Fax Number	:	847-358-5896

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. REGINA DZIEWIOR
Credential	:	M.A.
Telephone Number	:	847-358-2896

Provider Enumeration Date	:	02/29/2008
Last Update Date	:	02/29/2008

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