Provider Demographics
NPI:1679814214
Name:CARYN KEDZIERSKI
Entity Type:Organization
Organization Name:CARYN KEDZIERSKI
Other - Org Name:BEST HEARING OF LIBERTYVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ AUDIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:CARYN
Authorized Official - Middle Name:
Authorized Official - Last Name:KEDZIERSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MA,CCC-A
Authorized Official - Phone:847-438-2899
Mailing Address - Street 1:5 CHERRY HILL CIR
Mailing Address - Street 2:
Mailing Address - City:HAWTHORN WOODS
Mailing Address - State:IL
Mailing Address - Zip Code:60047-9220
Mailing Address - Country:US
Mailing Address - Phone:847-438-2899
Mailing Address - Fax:
Practice Address - Street 1:1880 W WINCHESTER RD
Practice Address - Street 2:SUITE 103
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-5341
Practice Address - Country:US
Practice Address - Phone:847-816-1116
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-06
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147000396231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1538216007OtherNPI
IL1538216007OtherNPI