Provider Demographics
NPI:1336428150
Name:OBERHOLZ, JENNIFER LYNN (BC-HIS)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LYNN
Last Name:OBERHOLZ
Suffix:
Gender:F
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:533 W NORTH AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-2135
Mailing Address - Country:US
Mailing Address - Phone:630-834-9911
Mailing Address - Fax:630-834-0778
Practice Address - Street 1:533 W NORTH AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-2135
Practice Address - Country:US
Practice Address - Phone:630-834-9911
Practice Address - Fax:630-834-0778
Is Sole Proprietor?:No
Enumeration Date:2011-08-10
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2742237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist