Provider Demographics
NPI:1326700808
Name:FIELD, AMY (HID)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:
Last Name:FIELD
Suffix:
Gender:F
Credentials:HID
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 S PARK CREST DR
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:IL
Mailing Address - Zip Code:61032-7802
Mailing Address - Country:US
Mailing Address - Phone:815-235-3277
Mailing Address - Fax:
Practice Address - Street 1:610 S PARK CREST DR
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:IL
Practice Address - Zip Code:61032-7802
Practice Address - Country:US
Practice Address - Phone:815-235-3277
Practice Address - Fax:815-349-7294
Is Sole Proprietor?:No
Enumeration Date:2021-10-12
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL3460237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL3460OtherHID