Provider Demographics
NPI:1396851408
Name:SHEETS, GREGORY B (AUD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:B
Last Name:SHEETS
Suffix:
Gender:M
Credentials:AUD
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Mailing Address - Street 1:215 SHUMAN BLVD
Mailing Address - Street 2:STE 401
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-8458
Mailing Address - Country:US
Mailing Address - Phone:630-303-5380
Mailing Address - Fax:978-313-6824
Practice Address - Street 1:1703 CREEKSIDE LOOP
Practice Address - Street 2:SUITE 100
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-4875
Practice Address - Country:US
Practice Address - Phone:509-453-8600
Practice Address - Fax:509-453-8616
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WALD00001015237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
1979SHOtherREGENCE BLUE SHIELD
A002OtherTRICARE
770619165OtherFIRST CHOICE PPO
96278OtherHEAR PO
1019335OtherCHPW
770619165OtherMOLINA HEALTHCARE OF WA
8338378OtherDSHS
181518OtherLABOR AND INDUSTRIES
WA8801076Medicare UPIN
8801076OtherMEDICARE B
P00124493OtherRAILROAD MEDICARE
UNIFORM MEDICAL PLANOther770616165
UNITED HEALTH NETWOROther770619165
770619165OtherPREMA BLUE CROSS
8931875OtherCRIME VICTIMS
D87318OtherRR MC GROUP NUMBERS