NPI 1194593079 · live from the CMS NPI Registry
Samantha Bloodgood, Au.D.
Audiologist in Park Ridge, IL. National Provider Identifier 1194593079, active.
NPI record
| NPI | 1194593079 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Audiologist 231H00000X |
| Practice location | 2604 Dempster St Ste 501, Park Ridge, IL 60068 |
| Practice phone | 847-674-5585 |
| Mailing address | 2246 W Lawrence Ave Unit 402, Chicago, IL 60625 |
| Enumerated | December 19, 2023 |
| Last updated | May 8, 2024 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Audiologist primary | 231H00000X | 147.001985 (IL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.