Basic Information
| Provider Information | |||||||||
| NPI: | 1609140094 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | HEARING PROFESSIONALS OF AMERICA LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3108 S ROUTE 59 | ||||||||
| Address2: | SUITE 124-295 | ||||||||
| City: | NAPERVILLE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605648021 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8886121267 | ||||||||
| FaxNumber: | 8156763997 | ||||||||
| Practice Location | |||||||||
| Address1: | 313 S CAROL MALONE BLVD | ||||||||
| Address2: | |||||||||
| City: | GRAYSON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 411431357 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8886121267 | ||||||||
| FaxNumber: | 8156763997 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/02/2012 | ||||||||
| LastUpdateDate: | 03/02/2012 | ||||||||
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| AuthorizedOfficialLastName: | CONREY | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
| AuthorizedOfficialMiddleName: | BIRAN | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER CEO | ||||||||
| AuthorizedOfficialTelephone: | 8886121267 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | HEARING PROFESSIONALS OF AMERICA LLC | ||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332S00000X | Y | Suppliers | Hearing Aid Equipment |
No ID Information.