Provider Demographics
NPI:1225212020
Name:NU-TONE HEARING CLINIC INC
Entity Type:Organization
Organization Name:NU-TONE HEARING CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SHAREHOLDER
Authorized Official - Prefix:DR
Authorized Official - First Name:STAVROS
Authorized Official - Middle Name:
Authorized Official - Last Name:BASSEAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-271-1192
Mailing Address - Street 1:5962 N LINCOLN AVE
Mailing Address - Street 2:STE U2
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659-3711
Mailing Address - Country:US
Mailing Address - Phone:773-271-1192
Mailing Address - Fax:
Practice Address - Street 1:5962 N LINCOLN AVE
Practice Address - Street 2:STE U2
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-3711
Practice Address - Country:US
Practice Address - Phone:773-271-1192
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-28
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1954332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid