Provider Demographics
NPI:1245535418
Name:BENNINGTON, ANDREW S
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:S
Last Name:BENNINGTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 W HIGGINS RD
Mailing Address - Street 2:STE 120
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-2006
Mailing Address - Country:US
Mailing Address - Phone:847-843-1900
Mailing Address - Fax:847-843-1901
Practice Address - Street 1:5016 N UNIVERSITY ST
Practice Address - Street 2:STE 110
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61614-4781
Practice Address - Country:US
Practice Address - Phone:309-693-2717
Practice Address - Fax:309-693-2776
Is Sole Proprietor?:No
Enumeration Date:2011-01-20
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist