Provider Demographics
NPI:1164612727
Name:ASSOCIATED HEARING SERVICES, P.C.
Entity Type:Organization
Organization Name:ASSOCIATED HEARING SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/AUDIOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:WYNNETTE
Authorized Official - Middle Name:J
Authorized Official - Last Name:MONEKA
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC/A
Authorized Official - Phone:708-422-3500
Mailing Address - Street 1:3860 W 95TH ST
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60805-2034
Mailing Address - Country:US
Mailing Address - Phone:708-422-3500
Mailing Address - Fax:708-422-3989
Practice Address - Street 1:3860 W 95TH ST
Practice Address - Street 2:
Practice Address - City:EVERGREEN PARK
Practice Address - State:IL
Practice Address - Zip Code:60805-2034
Practice Address - Country:US
Practice Address - Phone:708-422-3500
Practice Address - Fax:708-422-3989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-30
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147000328231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01621288OtherBLUE CROSS BLUE SHIELD
IL640003234OtherRAILROAD RETIREMENT BOARD
IL352344015001Medicaid
IL352344015001Medicaid