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12910 S La Grange Rd, Palos Park, IL 60464-1717 | |
(708) 448-1234 | |
(708) 448-1402 |
Full Name | |
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Type | Facility |
Speciality | Audiologist |
Location | 12910 S La Grange Rd, Palos Park, Illinois |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1932526944 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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231H00000X | Audiologist | 147-000952 (Illinois) | Primary |
Provider Name | Kristen M Conners |
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Provider Type | Practitioner - Qualified Audiologist |
Provider Identifiers | NPI Number: 1164635280 PECOS PAC ID: 8921171596 Enrollment ID: I20080716000250 |
Provider Name | Jaclyn Ann Sullivan |
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Provider Type | Practitioner - Qualified Speech Language Pathologist |
Provider Identifiers | NPI Number: 1700432424 PECOS PAC ID: 7416395744 Enrollment ID: I20240405001993 |
Mailing Address | Practice Location Address |
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12910 S La Grange Rd, Palos Park, IL 60464-1717 Ph: (708) 448-1234 | 12910 S La Grange Rd, Palos Park, IL 60464-1717 Ph: (708) 448-1234 |
Mrs. Kristen Marie Conners, M.S., CCC-A Audiologist Medicare: Medicare Enrolled Practice Location: 12910 S La Grange Rd, Palos Park, IL 60464 Phone: 708-448-1234 Fax: 708-448-1402 |