Provider Demographics
NPI:1114104239
Name:HEARING AID CENTER OF HINSDALE
Entity Type:Organization
Organization Name:HEARING AID CENTER OF HINSDALE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:WIET
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-789-3110
Mailing Address - Street 1:11 SALT CREEK LN
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-2902
Mailing Address - Country:US
Mailing Address - Phone:630-789-3110
Mailing Address - Fax:630-789-3137
Practice Address - Street 1:11 SALT CREEK LN
Practice Address - Street 2:SUITE 100
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-2902
Practice Address - Country:US
Practice Address - Phone:630-789-3110
Practice Address - Fax:630-789-3137
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EAR INSTITUTE OF CHICAGO LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-31
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech