Provider Demographics
NPI:1639480890
Name:MOBILE AUDIOLOGY SERVICES INC
Entity Type:Organization
Organization Name:MOBILE AUDIOLOGY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SARGON
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAMO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-459-7512
Mailing Address - Street 1:122 W SAINT CHARLES RD
Mailing Address - Street 2:SUITE 4A
Mailing Address - City:VILLA PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60181-2437
Mailing Address - Country:US
Mailing Address - Phone:800-459-7512
Mailing Address - Fax:800-459-7593
Practice Address - Street 1:122 W SAINT CHARLES RD
Practice Address - Street 2:SUITE 4A
Practice Address - City:VILLA PARK
Practice Address - State:IL
Practice Address - Zip Code:60181-2437
Practice Address - Country:US
Practice Address - Phone:800-459-7512
Practice Address - Fax:800-459-7593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-23
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty