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NPI Code Detail

MEDICARE: KYLE ALLEN FUNFSINN HAD

MEDICARE: KYLE ALLEN FUNFSINN HAD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1237700000XHearing Instrument Specialist3649IL

General Provider Information

NPI Number : 1518821602
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYLE ALLEN FUNFSINN HAD
Provider Business Mailing Address
First Line : 421 N 20TH ST APT 102
Second Line :
City : QUINCY
State : IL
Zip : 62301-2848
Country : US
Telephone Number : 217-640-5904
Fax Number :
Provider Business Practice Location Address
First Line : 700 N 54TH ST STE 105
Second Line :
City : QUINCY
State : IL
Zip : 62305-7909
Country : US
Telephone Number : 217-640-5904
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2025
Last Update Date : 12/12/2025

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Directions to “ KYLE ALLEN FUNFSINN HAD” Practice Location

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