Provider Demographics
NPI:1871702860
Name:MIDWEST HEARING CONSULTANTS GROUP, INC.
Entity type:Organization
Organization Name:MIDWEST HEARING CONSULTANTS GROUP, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT,CONSULTANT DISPENSER
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:S
Authorized Official - Last Name:HEATON
Authorized Official - Suffix:
Authorized Official - Credentials:STATE LICENSED
Authorized Official - Phone:618-548-0024
Mailing Address - Street 1:313 RODDY RD
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:IL
Mailing Address - Zip Code:62881-3836
Mailing Address - Country:US
Mailing Address - Phone:618-548-0024
Mailing Address - Fax:618-548-2403
Practice Address - Street 1:235 SAINT CLAIR SQ
Practice Address - Street 2:
Practice Address - City:FAIRVIEW HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:62208-2134
Practice Address - Country:US
Practice Address - Phone:618-624-8805
Practice Address - Fax:618-206-2318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2627237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty