Provider Demographics
NPI:1891017901
Name:INSTITUTE OF ACCENT MODIFICATION, INC.
Entity Type:Organization
Organization Name:INSTITUTE OF ACCENT MODIFICATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:INGRAM
Authorized Official - Suffix:
Authorized Official - Credentials:MA, MS
Authorized Official - Phone:312-635-0099
Mailing Address - Street 1:28 E JACKSON BLVD
Mailing Address - Street 2:SUITE #10-A850
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60604-2263
Mailing Address - Country:US
Mailing Address - Phone:312-635-0099
Mailing Address - Fax:888-203-5297
Practice Address - Street 1:125 S WACKER DR
Practice Address - Street 2:SUITE 300
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60606-4424
Practice Address - Country:US
Practice Address - Phone:312-635-0099
Practice Address - Fax:888-203-5297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-17
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147000563261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech