Provider Demographics
NPI:1578745055
Name:PRAIRIELAND AUDIOLOGY LLC
Entity Type:Organization
Organization Name:PRAIRIELAND AUDIOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:PASTELL
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:815-744-5661
Mailing Address - Street 1:2121 ONEIDA ST
Mailing Address - Street 2:SUITE 303
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-6544
Mailing Address - Country:US
Mailing Address - Phone:815-744-5661
Mailing Address - Fax:815-744-5662
Practice Address - Street 1:2121 ONEIDA ST
Practice Address - Street 2:SUITE 303
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-6544
Practice Address - Country:US
Practice Address - Phone:815-744-5661
Practice Address - Fax:815-744-5662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-27
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty