Provider Demographics
NPI:1033591102
Name:ELDREDGE, LYNNE MARIE (HIS)
Entity Type:Individual
Prefix:MRS
First Name:LYNNE
Middle Name:MARIE
Last Name:ELDREDGE
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 W ALGONQUIN RD
Mailing Address - Street 2:
Mailing Address - City:LAKE IN THE HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60156-1292
Mailing Address - Country:US
Mailing Address - Phone:847-458-2527
Mailing Address - Fax:
Practice Address - Street 1:2400 W ALGONQUIN RD
Practice Address - Street 2:
Practice Address - City:LAKE IN THE HILLS
Practice Address - State:IL
Practice Address - Zip Code:60156-1292
Practice Address - Country:US
Practice Address - Phone:847-458-2527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-24
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2540237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist