Provider Demographics
NPI:1932473345
Name:AUDIOLOGY INNOVATIONS, P.C.
Entity Type:Organization
Organization Name:AUDIOLOGY INNOVATIONS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF AUDIOLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:MCKEE
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:815-751-6691
Mailing Address - Street 1:816 S ELDORADO RD STE 1
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61704-6035
Mailing Address - Country:US
Mailing Address - Phone:309-662-8346
Mailing Address - Fax:309-662-0479
Practice Address - Street 1:816 S ELDORADO RD STE 1
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61704-6035
Practice Address - Country:US
Practice Address - Phone:309-662-8346
Practice Address - Fax:309-662-0479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-02
Last Update Date:2017-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147-001154231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty