Provider Demographics
NPI:1841200714
Name:SUSAN ROGAN HEARING INC.
Entity Type:Organization
Organization Name:SUSAN ROGAN HEARING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROGAN
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:630-969-1677
Mailing Address - Street 1:1501 OGDEN AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-2742
Mailing Address - Country:US
Mailing Address - Phone:630-969-1677
Mailing Address - Fax:630-969-4384
Practice Address - Street 1:1501 OGDEN AVE
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-2742
Practice Address - Country:US
Practice Address - Phone:630-969-1677
Practice Address - Fax:630-969-4384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147000150231H00000X, 237600000X, 237600000X
IL147000391231H00000X, 237600000X
IL147000238237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL363670Medicare PIN