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Organization
NORTHWEST PROFESSIONAL HEARING CENTERS, INC.
Active
Organization
NORTHWEST PROFESSIONAL HEARING CENTERS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CRAIG A. MICHALAK (VICE PRESIDENT)
(708) 579-9458
Entity
Organization
Contact information
Practice address
6555 WILLOW SPRINGS RD, SUITE 11, LA GRANGE HIGHLANDS, IL 60525-4591
(708) 579-9458
(708) 579-9561
Mailing address
6555 WILLOW SPRINGS RD, SUITE 11, LA GRANGE HIGHLANDS, IL 60525-4591
(708) 579-9458
(708) 579-9561
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
2830
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01633818
BLUECROSS BLUESHIELD
IL
01
—
1912037839
PROVIDER JILL MICHALAK
IL
05
—
346563304001
—
IL
Enumeration date
06/18/2007
Last updated
08/22/2020
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