Provider Demographics
NPI:1538340468
Name:MCGLONE, SHERI L (BC HIS)
Entity type:Individual
Prefix:MRS
First Name:SHERI
Middle Name:L
Last Name:MCGLONE
Suffix:
Gender:F
Credentials:BC HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3415 CALUMET AVE
Mailing Address - Street 2:EXELA HEARING SERVICES
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-5427
Mailing Address - Country:US
Mailing Address - Phone:920-652-0190
Mailing Address - Fax:920-652-0178
Practice Address - Street 1:3415 CALUMET AVE
Practice Address - Street 2:EXELA HEARING SERVICES
Practice Address - City:MANITOWOC
Practice Address - State:WI
Practice Address - Zip Code:54220-5427
Practice Address - Country:US
Practice Address - Phone:920-652-0190
Practice Address - Fax:920-652-0178
Is Sole Proprietor?:No
Enumeration Date:2007-11-20
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI929237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42826700Medicaid