Provider Demographics
NPI:1760763908
Name:STREATOR HEARING CARE LLC
Entity Type:Organization
Organization Name:STREATOR HEARING CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DARCY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BEALS
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-A
Authorized Official - Phone:815-673-2869
Mailing Address - Street 1:205 S PARK ST
Mailing Address - Street 2:
Mailing Address - City:STREATOR
Mailing Address - State:IL
Mailing Address - Zip Code:61364-4448
Mailing Address - Country:US
Mailing Address - Phone:815-673-2869
Mailing Address - Fax:815-672-9225
Practice Address - Street 1:205 S PARK ST
Practice Address - Street 2:
Practice Address - City:STREATOR
Practice Address - State:IL
Practice Address - Zip Code:61364-4448
Practice Address - Country:US
Practice Address - Phone:815-673-2869
Practice Address - Fax:815-672-9225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-01
Last Update Date:2016-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147.000596231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty