Provider Demographics
NPI:1962741744
Name:LG HEARING & AUDIOLOGY
Entity type:Organization
Organization Name:LG HEARING & AUDIOLOGY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DOLORES
Authorized Official - Middle Name:
Authorized Official - Last Name:LAROSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-593-1110
Mailing Address - Street 1:600 N DEARBORN ST
Mailing Address - Street 2:SUITE 1308
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-6284
Mailing Address - Country:US
Mailing Address - Phone:312-730-7339
Mailing Address - Fax:
Practice Address - Street 1:597 N YORK ST
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-1903
Practice Address - Country:US
Practice Address - Phone:630-833-8382
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-13
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty