Provider Demographics
NPI:1083924799
Name:WIRTZ, KATHLEEN M (HEARING AID DEALER)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:M
Last Name:WIRTZ
Suffix:
Gender:F
Credentials:HEARING AID DEALER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 W HIGGINS RD STE 120
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-2006
Mailing Address - Country:US
Mailing Address - Phone:847-843-1900
Mailing Address - Fax:847-843-1901
Practice Address - Street 1:557 EMMETT ST E
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49017-5682
Practice Address - Country:US
Practice Address - Phone:269-965-3305
Practice Address - Fax:269-965-8809
Is Sole Proprietor?:No
Enumeration Date:2010-10-15
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist