Organization
NORTH SIDE AUDIOLOGY GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DARIA T POPOWYCH MS CCCA (AUDIOLOGIST)
(773) 777-3277
Entity
Organization
Contact information
Practice address
4200 W. PETERSON AVE., SUITE 100, CHICAGO, IL 60646-6052
(773) 777-3277
(773) 777-2878
Mailing address
4200 W. PETERSON AVE., SUITE 100, CHICAGO, IL 60646-6052
(773) 777-3277
(773) 777-2878
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
147000241
IL
231H00000X
Audiologist
147000271
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
265496573001
—
IL
05
—
333608331001
—
IL
Enumeration date
03/08/2007
Last updated
12/07/2012
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