Healthcare Provider Details

I. General information

NPI: 1447379888
Provider Name (Legal Business Name): REGNIERS HEARING AID SERVICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 02/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2617 N KNOXVILLE AVE
PEORIA IL
61604-3623
US

IV. Provider business mailing address

2617 N KNOXVILLE AVE
PEORIA IL
61604-3623
US

V. Phone/Fax

Practice location:
  • Phone: 309-685-0887
  • Fax: 309-685-0891
Mailing address:
  • Phone: 309-685-0887
  • Fax: 309-685-0891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number0001
License Number StateIL

VIII. Authorized Official

Name: MR. THOMAS L REGNIER
Title or Position: PRESIDENT
Credential: CCC A ACA
Phone: 309-685-0887