Provider Demographics
NPI:1134268758
Name:CLIFTON, ANN E (AUD, CCC-A)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:E
Last Name:CLIFTON
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5644 LINWORTH RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-3355
Mailing Address - Country:US
Mailing Address - Phone:847-267-8200
Mailing Address - Fax:847-267-9440
Practice Address - Street 1:775 WAUKEGAN RD
Practice Address - Street 2:SUITE 200
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-4342
Practice Address - Country:US
Practice Address - Phone:847-580-5954
Practice Address - Fax:847-267-9440
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA.01473231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000515859OtherANTHEM BCBS
OH000000543942OtherANTHEM BCBS
OH2715324Medicaid
OHCL4138084Medicare PIN
OHCL4138083Medicare PIN
OHP00387228Medicare PIN
OHP00431535Medicare PIN