NPI 1194056564 · live from the CMS NPI Registry
Candace R Blank, Au.D.
Audiologist in Maywood, IL. National Provider Identifier 1194056564, active.
NPI record
| NPI | 1194056564 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Audiologist 231H00000X |
| Practice location | 2160 S 1st Ave, Department Of Audiology, Maywood, IL 60153 |
| Practice phone | 708-216-3821 |
| Enumerated | January 24, 2010 |
| Last updated | April 1, 2021 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Audiologist primary | 231H00000X | 147000175 (IL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.