Provider Demographics
NPI:1770901753
Name:RISLEY, ROBERT (AUD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:RISLEY
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 OAKBROOK CTR
Mailing Address - Street 2:SUITE # 709
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1806
Mailing Address - Country:US
Mailing Address - Phone:630-571-7111
Mailing Address - Fax:630-571-7115
Practice Address - Street 1:120 OAKBROOK CTR
Practice Address - Street 2:SUITE # 709
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-1806
Practice Address - Country:US
Practice Address - Phone:630-571-7111
Practice Address - Fax:630-571-7115
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-07
Last Update Date:2014-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147.001472237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter