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 Field Definition 1
1 NPI 1326180837 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 1 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Provider Last Name Legal Name LAROSE The last name of the provider. If the provider is an individual, this is the legal name.
4 Provider First Name ROGER The first name of the provider, if the provider is an individual.
5 Provider Middle Name WALTER The middle name of the provider, if the provider is an individual.
6 Provider Name Prefix Text MR. The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
7 Provider Credential Text M.A. The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
8 Provider First Line Business Practice Location Address 1034 WARREN AVE The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
9 Provider Business Practice Location Address City Name DOWNERS GROVE The city name in the location address of the provider being identified.
10 Provider Business Practice Location Address State Name IL The State code in the location of the provider being identified.
11 Provider Business Practice Location Address Postal Code 605153601 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
12 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
13 Provider Business Practice Location Address Telephone Number 3123007477 The telephone number associated with the location address of the provider being identified.
14 Provider Enumeration Date 2/12/2007 The date the provider was assigned a unique identifier (assigned an NPI).
15 Last Update Date 10/22/2014 The date that a record was last updated or changed.
16 Provider Gender Code M The code designating the provider’s gender if the provider is a person.
17 Healthcare Provider Taxonomy Code 1 231H00000X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
18 Provider License Number 1 147000224 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
19 Provider License Number State Code 1 IL The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
20 Healthcare Provider Primary Taxonomy Switch 1 Y
21 Other Provider Identifier 1 K10740 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
22 Other Provider Identifier Type Code 1 04 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
23 Other Provider Identifier State 1 IL
24 Is Sole Proprietor Y Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No

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This page was last updated on: 3/10/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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