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General NPI Number Information
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NPI Number | 1891308573
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Entity Type | Organization
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Legal Business Name | SCHACKMANN HEARING GROUP LLC
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Dates
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Enumeration Date | 08/24/2020
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Last Update Date | 08/24/2020
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Provider Practice Location Address
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Address Line | 212 E JEFFERSON AVE STE 2
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City | EFFINGHAM
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State | IL
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Zip | 62401-3458
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Country | US
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Telephone | 217-342-0304
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Fax |
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Provider Business Mailing Address
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Address Line | 212 E JEFFERSON AVE STE 2
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City | EFFINGHAM
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State | IL
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Zip | 62401-3458
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Country | US
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Telephone | 217-342-0304
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Fax |
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Authorized Official
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Title or Position | OWNER/HEARING INSTRUMENT DISPENSER
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Name | KERRI DEE SCHACKMANN
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Credential | HID
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Telephone | 618-214-8358
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number |
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License Number State |
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