Provider Demographics
NPI:1740762269
Name:THEOS AUDIOLOGY SOLUTIONS LLC
Entity Type:Organization
Organization Name:THEOS AUDIOLOGY SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KENDRA
Authorized Official - Middle Name:L
Authorized Official - Last Name:THEODOSOPOULOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-257-2660
Mailing Address - Street 1:2200 MARQUETTE RD STE 115
Mailing Address - Street 2:
Mailing Address - City:PERU
Mailing Address - State:IL
Mailing Address - Zip Code:61354-1587
Mailing Address - Country:US
Mailing Address - Phone:815-223-1100
Mailing Address - Fax:
Practice Address - Street 1:2200 MARQUETTE RD STE 115
Practice Address - Street 2:
Practice Address - City:PERU
Practice Address - State:IL
Practice Address - Zip Code:61354-1587
Practice Address - Country:US
Practice Address - Phone:815-223-1100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-31
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech