Provider Demographics
NPI:1366601445
Name:MAS AUDIOLOGY, LLC
Entity type:Organization
Organization Name:MAS AUDIOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SARGON
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAMO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-939-6053
Mailing Address - Street 1:962 N NORTHWEST HWY
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-2358
Mailing Address - Country:US
Mailing Address - Phone:847-939-6053
Mailing Address - Fax:847-939-6071
Practice Address - Street 1:962 N NORTHWEST HWY
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-2358
Practice Address - Country:US
Practice Address - Phone:847-939-6053
Practice Address - Fax:847-939-6071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-04
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty