Provider Demographics
NPI:1932384674
Name:NAPERVILLE HEARING SERVICES
Entity Type:Organization
Organization Name:NAPERVILLE HEARING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AUDIOLOGIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:J
Authorized Official - Last Name:SIEFERT
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:630-960-0213
Mailing Address - Street 1:5480 CASCADE DR
Mailing Address - Street 2:
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-2043
Mailing Address - Country:US
Mailing Address - Phone:630-960-0213
Mailing Address - Fax:
Practice Address - Street 1:10 W MARTIN AVE
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6535
Practice Address - Country:US
Practice Address - Phone:630-355-5668
Practice Address - Fax:630-355-2071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-31
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147-000266231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2225522OtherBLUE SHIELD NUMBER