Healthcare Provider Details

I. General information

NPI: 1649301094
Provider Name (Legal Business Name): PRO EAR INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 08/24/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 N. PERRYVILLE RD SUITE #2
ROCKFORD IL
61107-6232
US

IV. Provider business mailing address

801 N. PERRYVILLE RD SUITE #2
ROCKFORD IL
61107-6232
US

V. Phone/Fax

Practice location:
  • Phone: 815-397-4327
  • Fax: 815-397-4341
Mailing address:
  • Phone: 815-397-4327
  • Fax: 815-397-4341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State

VIII. Authorized Official

Name: MR. CHRIS ANTHONY HAYNES
Title or Position: OWNER/PRESIDENT
Credential: B.C., NBC-HIS AUDIOP
Phone: 815-988-1830