MEDICARE: GN HEARING CARE CORPORATION

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	261QH0700X	Hearing and Speech Clinic/Center

General Provider Information

NPI Number	:	1891219622
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GN HEARING CARE CORPORATION

Provider Business Mailing Address
First Line	:	2601 PATRIOT BLVD
Second Line	:
City	:	GLENVIEW
State	:	IL
Zip	:	60026-8023
Country	:	US
Telephone Number	:	847-832-3695
Fax Number	:	847-832-3665

Provider Business Practice Location Address
First Line	:	4650 S CLEVELAND AVE STE 3B
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-1372
Country	:	US
Telephone Number	:	239-225-6759
Fax Number	:	239-277-1660

Authorized Official
Title or Position	:	RETAIL STAFF ACCOUNTANT
Name	:	MR. JOHN PATRICK MCELVOGUE
Credential	:
Telephone Number	:	847-832-3695

Provider Enumeration Date	:	08/02/2017
Last Update Date	:	08/02/2017

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