Provider Demographics
NPI:1114375649
Name:LAND OF LINCOLN HEARING, INC.
Entity Type:Organization
Organization Name:LAND OF LINCOLN HEARING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN OF THE BOARD
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-325-4327
Mailing Address - Street 1:1313 W WINONA ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-2909
Mailing Address - Country:US
Mailing Address - Phone:630-346-1355
Mailing Address - Fax:
Practice Address - Street 1:1010 LAKE ST
Practice Address - Street 2:SUITE 200
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60301-1147
Practice Address - Country:US
Practice Address - Phone:630-346-1355
Practice Address - Fax:630-933-9999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-25
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2871237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty