Provider Demographics
NPI:1528272150
Name:GLAY, KAREN (AUD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:
Last Name:GLAY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5063 SHORELINE RD
Mailing Address - Street 2:SUBURBAN HEARING SERVICES, LLC
Mailing Address - City:LAKE BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-1700
Mailing Address - Country:US
Mailing Address - Phone:847-382-6010
Mailing Address - Fax:847-382-9243
Practice Address - Street 1:5063 SHORELINE RD
Practice Address - Street 2:SUBURBAN HEARING SERVICES, LLC
Practice Address - City:LAKE BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-1700
Practice Address - Country:US
Practice Address - Phone:847-382-6010
Practice Address - Fax:847-382-9243
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147000363231H00000X, 231HA2400X, 231HA2500X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
No231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Supplier
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL03107OtherHEARUSA
IL4910569OtherBLUECROSSBLUESHIELD
IL03107OtherHEARUSA