Provider Demographics
NPI:1982295804
Name:HEARING AND BALANCE SPECIALISTS OF ILLINOIS LLC
Entity type:Organization
Organization Name:HEARING AND BALANCE SPECIALISTS OF ILLINOIS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:SUMRALL
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:815-239-0673
Mailing Address - Street 1:21124 WASHINGTON PKWY
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-3112
Mailing Address - Country:US
Mailing Address - Phone:815-239-0673
Mailing Address - Fax:815-412-2985
Practice Address - Street 1:21124 WASHINGTON PKWY
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-3112
Practice Address - Country:US
Practice Address - Phone:815-239-0673
Practice Address - Fax:815-412-2985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-02
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty