Provider Demographics
NPI:1366918864
Name:GEAR, ANN
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:GEAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18160 W GAGES LAKE RD
Mailing Address - Street 2:
Mailing Address - City:GAGES LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030-1819
Mailing Address - Country:US
Mailing Address - Phone:847-986-2343
Mailing Address - Fax:
Practice Address - Street 1:18160 W GAGES LAKE RD
Practice Address - Street 2:
Practice Address - City:GAGES LAKE
Practice Address - State:IL
Practice Address - Zip Code:60030-1819
Practice Address - Country:US
Practice Address - Phone:847-986-2343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-23
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147000319231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL147-000319OtherIDFPR