Provider Demographics
NPI:1275411639
Name:ELE, VIGNAN (AUD)
Entity type:Individual
Prefix:DR
First Name:VIGNAN
Middle Name:
Last Name:ELE
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 GLENDALE BLVD APT 107
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-3145
Mailing Address - Country:US
Mailing Address - Phone:417-353-4909
Mailing Address - Fax:
Practice Address - Street 1:10855 VIRGINIA ST
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-0210
Practice Address - Country:US
Practice Address - Phone:219-407-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN23002931A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist