Healthcare Provider Details

I. General information

NPI: 1588701460
Provider Name (Legal Business Name): GCH INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 09/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

645 1ST ST
LA SALLE IL
61301-2418
US

IV. Provider business mailing address

645 1ST ST
LA SALLE IL
61301-2418
US

V. Phone/Fax

Practice location:
  • Phone: 815-224-2445
  • Fax: 815-224-2575
Mailing address:
  • Phone: 815-224-2445
  • Fax: 815-224-2575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number0912
License Number StateIL

VIII. Authorized Official

Name: MR. GARY CHRISTOPHER HAMMERS
Title or Position: OWNER
Credential: NBC-HIS
Phone: 815-224-2445