Provider Demographics
NPI:1477937019
Name:PROFESSIONAL HEARING SERVICES, INC.
Entity Type:Organization
Organization Name:PROFESSIONAL HEARING SERVICES, INC.
Other - Org Name:PROFESSIONAL HEARING SOLUTIONS BY DR. JILL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JILL
Authorized Official - Middle Name:LYNNETTE
Authorized Official - Last Name:NESHAM
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:319-393-4673
Mailing Address - Street 1:1500 CENTER ST NE STE 102
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-5500
Mailing Address - Country:US
Mailing Address - Phone:319-393-4673
Mailing Address - Fax:319-200-4068
Practice Address - Street 1:1500 CENTER ST NE STE 102
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-5500
Practice Address - Country:US
Practice Address - Phone:319-393-4673
Practice Address - Fax:319-200-4068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-14
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00533261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1154332484OtherNPI