Provider Demographics
NPI:1215955315
Name:CHMELIK, RUDOLPH ALOYSIUS (MS CCC-A)
Entity type:Individual
Prefix:MR
First Name:RUDOLPH
Middle Name:ALOYSIUS
Last Name:CHMELIK
Suffix:
Gender:M
Credentials:MS CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3314 HYDE PARK AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-2134
Mailing Address - Country:US
Mailing Address - Phone:612-306-4164
Mailing Address - Fax:
Practice Address - Street 1:6770 MAYFIELD RD
Practice Address - Street 2:#210
Practice Address - City:MAYFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44124-2299
Practice Address - Country:US
Practice Address - Phone:440-461-0766
Practice Address - Fax:440-461-8221
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2015-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7737231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist