Provider Demographics
NPI:1023344207
Name:AUDIO ADVANTAGE AIDS
Entity type:Organization
Organization Name:AUDIO ADVANTAGE AIDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, H.I.S.
Authorized Official - Prefix:MS
Authorized Official - First Name:JEANETTE
Authorized Official - Middle Name:R
Authorized Official - Last Name:HUPP
Authorized Official - Suffix:
Authorized Official - Credentials:HIS
Authorized Official - Phone:773-348-8760
Mailing Address - Street 1:4210 W MONTROSE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60641-2002
Mailing Address - Country:US
Mailing Address - Phone:773-348-8760
Mailing Address - Fax:
Practice Address - Street 1:4210 W MONTROSE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60641-2002
Practice Address - Country:US
Practice Address - Phone:773-348-8760
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-23
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0372295261QH0700X, 332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech