Provider Demographics
NPI:1891541496
Name:KOEHN, LINDSEY (AUD)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:KOEHN
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 1:108 W CHICAGO AVE APT 316
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-3204
Mailing Address - Country:US
Mailing Address - Phone:303-916-9816
Mailing Address - Fax:
Practice Address - Street 1:142 E ONTARIO ST STE 1100
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2818
Practice Address - Country:US
Practice Address - Phone:312-263-7171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-25
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147.001995231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist