Organization
WAUKEGAN HEARING AID CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PATRICIA M BOEHM (SECRETARY)
(847) 244-9154
Entity
Organization
Contact information
Practice address
1702 WASHINGTON ST, 200, WAUKEGAN, IL 60085-5153
(847) 336-0355
Mailing address
1702 WASHINGTON ST, 200, WAUKEGAN, IL 60085-5153
(847) 336-0355
Taxonomy
Speciality
Code
Description
License number
State
332S00000X
Hearing Aid Equipment
Primary
0007
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04922140
BLUE CROSS BLUE SHIELD
IL
01
—
0658752
AETNA
IL
01
—
830098
UNITED HEALTHCARE
IL
Enumeration date
01/23/2006
Last updated
08/22/2020
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