MEDICARE: MR. VINCENT ROY CHIQUET

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	237700000X	Hearing Instrument Specialist	HA2358	CA

General Provider Information

NPI Number	:	1992080840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. VINCENT ROY CHIQUET

Provider Business Mailing Address
First Line	:	2800 W HIGGINS RD STE 895
Second Line	:
City	:	HOFFMAN ESTATES
State	:	IL
Zip	:	60169-7228
Country	:	US
Telephone Number	:	847-843-1900
Fax Number	:	847-843-1901

Provider Business Practice Location Address
First Line	:	9300 W STOCKTON BLVD STE 205
Second Line	:
City	:	ELK GROVE
State	:	CA
Zip	:	95758-8070
Country	:	US
Telephone Number	:	916-691-0965
Fax Number	:	916-691-9758

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/11/2011
Last Update Date	:	10/11/2011

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