Organization
LINCOLN PARK HEARING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL JAMES SIEFERT M.A., CCC-A (VICE PRESIDENT)
(773) 883-3711
Entity
Organization
Contact information
Practice address
5480 CASCADE DR, LISLE, IL 60532-2043
(773) 883-3711
(773) 883-3764
Mailing address
550 W WEBSTER AVE, LINCOLN PARK HEARING CENTER, CHICAGO, IL 60614-3965
(773) 883-3711
(773) 883-3764
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001620960
BLUE CROSS BLUE SHIELD
IL
05
—
323429544-001
—
IL
05
—
344427601-001
—
IL
Enumeration date
01/08/2007
Last updated
08/22/2020
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