Provider Demographics
NPI:1396367173
Name:SPECIALIZED HEARING SOLUTIONS LLC
Entity Type:Organization
Organization Name:SPECIALIZED HEARING SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:HIS, LPN
Authorized Official - Phone:217-820-3462
Mailing Address - Street 1:775 N 1350 EAST RD
Mailing Address - Street 2:
Mailing Address - City:OWANECO
Mailing Address - State:IL
Mailing Address - Zip Code:62555-5517
Mailing Address - Country:US
Mailing Address - Phone:217-820-3462
Mailing Address - Fax:
Practice Address - Street 1:301 S WEBSTER ST
Practice Address - Street 2:
Practice Address - City:TAYLORVILLE
Practice Address - State:IL
Practice Address - Zip Code:62568-2150
Practice Address - Country:US
Practice Address - Phone:217-824-0411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-14
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty