Provider Demographics
NPI:1760652101
Name:HEARING CARE OF PALATINE, INC.
Entity Type:Organization
Organization Name:HEARING CARE OF PALATINE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:
Authorized Official - Last Name:DZIEWIOR
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:847-358-2896
Mailing Address - Street 1:305 E NORTHWEST HWY
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-8116
Mailing Address - Country:US
Mailing Address - Phone:847-358-2896
Mailing Address - Fax:847-358-5896
Practice Address - Street 1:305 E NORTHWEST HWY
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-8116
Practice Address - Country:US
Practice Address - Phone:847-358-2896
Practice Address - Fax:847-358-5896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147-000541231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
209180Medicare PIN