MEDICARE: MIDWEST AUDIOLOGY & HEARING CENTER SAUKVILLE LLC

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

General Provider Information

NPI Number	:	1902766512
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIDWEST AUDIOLOGY & HEARING CENTER SAUKVILLE LLC

Provider Business Mailing Address
First Line	:	620 E GREEN BAY AVE STE 110
Second Line	:
City	:	SAUKVILLE
State	:	WI
Zip	:	53080-2039
Country	:	US
Telephone Number	:	262-268-1400
Fax Number	:

Provider Business Practice Location Address
First Line	:	620 E GREEN BAY AVE STE 110
Second Line	:
City	:	SAUKVILLE
State	:	WI
Zip	:	53080-2039
Country	:	US
Telephone Number	:	262-268-1400
Fax Number	:

Authorized Official
Title or Position	:	CHIEF AUDIOLOGY OFFICER
Name	:	DR. DOUGLAS KLOSS
Credential	:	AUD
Telephone Number	:	414-281-8300

Provider Enumeration Date	:	11/15/2025
Last Update Date	:	11/15/2025

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