Organization
JOHN REIMBOLD
Active
Other names
Carbondale Hearing Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BETH A HICKS (OFFICE MANAGER)
(618) 457-6643
Entity
Organization
Contact information
Practice address
1717 W MAIN STREET, CARBONDALE, IL 62901
(618) 457-6643
(618) 457-6643
Mailing address
PO BOX 1058, 1717 W MAIN STREET, CARBONDALE, IL 62903-1058
(618) 457-6643
(618) 457-6643
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
147000156
IL
231H00000X
Audiologist
147000788
IL
231H00000X
Audiologist
147001158
IL
231H00000X
Audiologist
—
—
237700000X
Hearing Instrument Specialist
0394
IL
332B00000X
Durable Medical Equipment & Medical Supplies
2354
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
359446176001
—
IL
Enumeration date
07/28/2006
Last updated
10/13/2022
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