Provider Demographics
NPI:1912090515
Name:KNOX COUNTY HEARING
Entity Type:Organization
Organization Name:KNOX COUNTY HEARING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:SILBERER
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:309-342-0458
Mailing Address - Street 1:975 NORTH HENDERSON
Mailing Address - Street 2:
Mailing Address - City:GALESBURG
Mailing Address - State:IL
Mailing Address - Zip Code:61401-2577
Mailing Address - Country:US
Mailing Address - Phone:309-342-0458
Mailing Address - Fax:309-342-0458
Practice Address - Street 1:975 NORTH HENDERSON
Practice Address - Street 2:
Practice Address - City:GALESBURG
Practice Address - State:IL
Practice Address - Zip Code:61401-2577
Practice Address - Country:US
Practice Address - Phone:309-342-0458
Practice Address - Fax:309-342-0458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0040031416Medicare ID - Type UnspecifiedBCBS PROVIDER #
IL0040031415Medicare ID - Type UnspecifiedBCBS PROVIDER #