Provider Demographics
NPI:1982848172
Name:LIFETIME HEARING CENTERS NORTH WEST CHICAGO, LLC
Entity Type:Organization
Organization Name:LIFETIME HEARING CENTERS NORTH WEST CHICAGO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:HITTLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:BC-HIS
Authorized Official - Phone:847-975-8149
Mailing Address - Street 1:275 PARKWAY DR STE 415
Mailing Address - Street 2:
Mailing Address - City:LINCOLNSHIRE
Mailing Address - State:IL
Mailing Address - Zip Code:60069-4344
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:275 PARKWAY DR STE 415
Practice Address - Street 2:
Practice Address - City:LINCOLNSHIRE
Practice Address - State:IL
Practice Address - Zip Code:60069-4344
Practice Address - Country:US
Practice Address - Phone:847-975-8149
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LIFETIME HEARING CENTERS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-05-01
Last Update Date:2009-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty