MR. ROGER WALTER LAROSE, M.A. - NPI NUMBER 1326180837

Summary

Provider Name: MR. ROGER WALTER LAROSE, M.A.

NPI Number: 1326180837

Clasification: Audiologist (231H00000X)

Address:
1034 WARREN AVE
DOWNERS GROVE, IL
ZIP 60515

Phone Number: (312) 300-7477



Detailed Information

MR. Roger Walter Larose, M.A. is an audiologist in Downers Grove, IL. The provider is (1) A specialist in evaluation, habilitation and rehabilitation of those whose communication disorders center in whole or in part in hearing function. Audiologists are autonomous professionals who identify, assess, and manage disorders of the auditory, balance and other neural systems. Audiologists provide audiological (aural) rehabilitation to children and adults across the entire age span. Audiologists select, fit and dispense amplification systems such as hearing aids and related devices. (2) An audiologist is a person qualified by a master�s degree in audiology, licensed by the state, where applicable, and practicing within the scope of that license. Audiologists evaluate and treat patients with impaired hearing. They plan, direct and conduct rehabilitative programs with audiotry substitutional devises (hearing aids) and other therapy. The assigned NPI number for this provider is 1326180837 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business address is:

1034 WARREN AVE
DOWNERS GROVE, IL
ZIP 60515-601
Phone: (312) 300-7477

The enumeration date for this NPI number is 2/12/2007 and was last updated on 10/22/2014.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 231H00000X Audiologist 147000224 IL Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 K10740 MEDICARE ID-TYPE UNSPECIFIED IL

NPI Record

No. Field Name Field Value
1 NPI 1326180837
2 Entity Type Code 1
3 Provider Last Name Legal Name LAROSE
4 Provider First Name ROGER
5 Provider Middle Name WALTER
6 Provider Name Prefix Text MR.
7 Provider Credential Text M.A.
8 Provider First Line Business Practice Location Address 1034 WARREN AVE
9 Provider Business Practice Location Address City Name DOWNERS GROVE
10 Provider Business Practice Location Address State Name IL
11 Provider Business Practice Location Address Postal Code 605153601
12 Provider Business Practice Location Address Country Code If outside U S US
13 Provider Business Practice Location Address Telephone Number 3123007477
14 Provider Enumeration Date 2/12/2007
15 Last Update Date 10/22/2014
16 Provider Gender Code M
17 Healthcare Provider Taxonomy Code 1 231H00000X
18 Provider License Number 1 147000224
19 Provider License Number State Code 1 IL
20 Healthcare Provider Primary Taxonomy Switch 1 Y
21 Other Provider Identifier 1 K10740
22 Other Provider Identifier Type Code 1 04
23 Other Provider Identifier State 1 IL
24 Is Sole Proprietor Y

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This page was last updated on: 11/14/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.