Provider Demographics
NPI:1477934792
Name:CORNERSTONE HEARING CENTER LLC
Entity Type:Organization
Organization Name:CORNERSTONE HEARING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:MADIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:HIS
Authorized Official - Phone:847-457-1800
Mailing Address - Street 1:12545 FARM HILL DR
Mailing Address - Street 2:200
Mailing Address - City:HUNTLEY
Mailing Address - State:IL
Mailing Address - Zip Code:60142-7723
Mailing Address - Country:US
Mailing Address - Phone:847-457-1800
Mailing Address - Fax:847-457-1805
Practice Address - Street 1:12545 FARM HILL DR
Practice Address - Street 2:200
Practice Address - City:HUNTLEY
Practice Address - State:IL
Practice Address - Zip Code:60142-7723
Practice Address - Country:US
Practice Address - Phone:847-457-1800
Practice Address - Fax:847-457-1805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-11
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL3027174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1861792608Medicare PIN