Provider Demographics
NPI:1730105990
Name:MALESEVIC, KARYN LOUISE VOELS (AUD)
Entity Type:Individual
Prefix:
First Name:KARYN
Middle Name:LOUISE VOELS
Last Name:MALESEVIC
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:KARYN
Other - Middle Name:LOUISE
Other - Last Name:VOELS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:830 S ADDISON AVE
Mailing Address - Street 2:
Mailing Address - City:VILLA PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60181-2877
Mailing Address - Country:US
Mailing Address - Phone:630-620-4433
Mailing Address - Fax:630-620-1148
Practice Address - Street 1:830 S ADDISON AVE
Practice Address - Street 2:
Practice Address - City:VILLA PARK
Practice Address - State:IL
Practice Address - Zip Code:60181-2877
Practice Address - Country:US
Practice Address - Phone:630-620-4433
Practice Address - Fax:630-620-1148
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL231HA2400X, 231HA2500X, 237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
Not Answered231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Supplier
Not Answered237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK18396Medicare ID - Type Unspecified