1548565906 NPI number — ACCUQUEST HEARING CENTER

Table of content: (NPI 1548565906)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548565906 NPI number — ACCUQUEST HEARING CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ACCUQUEST HEARING CENTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1548565906
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/19/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2800 W HIGGINS ROAD
Provider Second Line Business Mailing Address:
SUITE #895
Provider Business Mailing Address City Name:
HOFFMAN ESTATES
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60169
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-843-1900
Provider Business Mailing Address Fax Number:
847-843-1901

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3940 CHEROKEE STREET
Provider Second Line Business Practice Location Address:
SUITE #407
Provider Business Practice Location Address City Name:
KENNESAW
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30144
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
770-590-7702
Provider Business Practice Location Address Fax Number:
770-590-7704
Provider Enumeration Date:
01/17/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CARLSON
Authorized Official First Name:
ASHLIE
Authorized Official Middle Name:
Authorized Official Title or Position:
INSURANCE MANAGER
Authorized Official Telephone Number:
847-843-1900

Provider Taxonomy Codes

  • Taxonomy code: 261QH0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)