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Organization
BLOOMINGTON NORMAL AUDIOLOGY
Active
Organization
BLOOMINGTON NORMAL AUDIOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEBORAH S PITCHER AUD (AUDIOLOGIST OWNER MANAGER)
(309) 662-8346
Entity
Organization
Contact information
Practice address
1404 EASTLAND DR, SUITE 203, BLOOMINGTON, IL 61701-3532
(309) 662-8346
(309) 662-0479
Mailing address
1404 EASTLAND DRIVE, SUITE 203, BLOOMINGTON, IL 61701
(309) 662-8346
(309) 662-0479
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
147000437
IL
231HA2400X
Assistive Technology Practitioner Audiologist
147000437
IL
231HA2500X
Assistive Technology Supplier Audiologist
147000437
IL
237600000X
Audiologist-Hearing Aid Fitter
147000437
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05715416
BCBS
IL
01
—
093818
HEALTH ALLIANCE
IL
01
—
CC4558
RAILROAD MEDICARE
IL
Enumeration date
10/11/2006
Last updated
09/20/2010
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