NPI 1396466405 · live from the CMS NPI Registry
Lauren Boaz
Audiologist in Peoria, IL. National Provider Identifier 1396466405, active.
NPI record
| NPI | 1396466405 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Audiologist 231H00000X |
| Practice location | 7717 N Orange Prairie Rd, Peoria, IL 61615 |
| Practice phone | 309-589-6800 |
| Mailing address | 201 E Madison St Ste 328, Springfield, IL 62702 |
| Enumerated | September 7, 2022 |
| Last updated | January 2, 2024 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Audiologist primary | 231H00000X | 147.001886 (IL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.