Evan A. Reimbold, HEARING INSTRUMENT D
Individual provider Active NPI Hearing Instrument Specialist · Carbendale, IL
NPI 1508152117 · NPPES record last updated Jun 22, 2011
Key facts
- NPI
- 1508152117
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Hearing Instrument Specialist 237700000X
- License
- 3009 (IL)
- Practice address
- 1717 W. Main Street
Carbendale, IL 62901 - Phone
- (618) 457-6643
- Fax
- (618) 457-6643
- NPI assigned
- Jun 22, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3009 | IL | MD | Hearing Instrument Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| John Reimbold | Hearing Instrument Specialist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hearing Instrument Specialist | 237700000X | 3009 | IL | Yes |
Addresses
Primary practice location
1717 W. Main Street
Carbendale, IL 62901
Mailing address
P.O. Box 1058
1717 W. Main Street
Carbendale, IL 62903-1058
Phone (618) 457-6643
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 22, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.