Healthcare Provider Details

I. General information

NPI: 1497169973
Provider Name (Legal Business Name): BRIAN LEE HASSINGER HIS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2014
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2605 N WATER ST STE 101
DECATUR IL
62526-3239
US

IV. Provider business mailing address

2605 N WATER ST STE 101
DECATUR IL
62526-3239
US

V. Phone/Fax

Practice location:
  • Phone: 217-519-9617
  • Fax:
Mailing address:
  • Phone: 217-519-9617
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number2465
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number2465
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: