Individual
KRYSTINE M. MULLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D., CCC/A
Contact information
Practice address
25 N. WINFIELD ROAD, SUITE 424, WINFIELD, IL 60190
(630) 933-4056
(630) 933-4057
Mailing address
25 N WINFIELD RD, WINFIELD, IL 60190-1295
(630) 933-4056
(630) 933-4057
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
147001149
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
206147
MEDICARE PTAN (GROUP)
IL
01
—
F400177515
MEDICARE PTAN (INDIVIDUAL)
IL
Enumeration date
01/16/2007
Last updated
05/05/2015
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