Provider Demographics
NPI:1023020518
Name:MOORE-SCHMITT, MELISSA M (MA, CCC-A)
Entity Type:Individual
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First Name:MELISSA
Middle Name:M
Last Name:MOORE-SCHMITT
Suffix:
Gender:F
Credentials:MA, CCC-A
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Mailing Address - Street 1:ADVANCED HEARING SYSTEMS LLC
Mailing Address - Street 2:4933 BENCHMARK CENTRE DRIVE, SUITE B
Mailing Address - City:SWANSEA
Mailing Address - State:IL
Mailing Address - Zip Code:62226-8927
Mailing Address - Country:US
Mailing Address - Phone:618-628-1212
Mailing Address - Fax:618-628-8520
Practice Address - Street 1:ADVANCED HEARING SYSTEMS
Practice Address - Street 2:4933 BENCHMARK CENTRE DRIVE, SUITE B
Practice Address - City:SWANSEA
Practice Address - State:IL
Practice Address - Zip Code:62226-8927
Practice Address - Country:US
Practice Address - Phone:618-628-1212
Practice Address - Fax:618-628-8520
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
231H00000X
IL147-000155231HA2400X, 231HA2500X, 237600000X, 237700000X, 231H00000X
IL147000155332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology PractitionerGroup - Multi-Specialty
No231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology SupplierGroup - Multi-Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL338636371001Medicaid
IL338636371001Medicaid