Individual
MS. JULIE A WIRTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUDIOLOGIST
Contact information
Practice address
611 W PARK ST, URBANA, IL 61801-2500
(217) 383-4375
(217) 326-2336
Mailing address
611 WEST PARK ST., FAPC, URBANA, IL 61801
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
147000912
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
113326
HEALTHLINK PROV ID
—
01
—
203
BLUE CROSS PROV ID
IL
05
—
371119538401
—
IL
01
—
4117
HAMP PROVIDER ID
IL
01
—
7216
PERSONALCARE PROV ID
—
Enumeration date
04/18/2007
Last updated
02/20/2024
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