Provider Demographics
NPI:1891308573
Name:SCHACKMANN HEARING GROUP LLC
Entity type:Organization
Organization Name:SCHACKMANN HEARING GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/HEARING INSTRUMENT DISPENSER
Authorized Official - Prefix:
Authorized Official - First Name:KERRI
Authorized Official - Middle Name:DEE
Authorized Official - Last Name:SCHACKMANN
Authorized Official - Suffix:
Authorized Official - Credentials:HID
Authorized Official - Phone:618-214-8358
Mailing Address - Street 1:212 E JEFFERSON AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:EFFINGHAM
Mailing Address - State:IL
Mailing Address - Zip Code:62401-3458
Mailing Address - Country:US
Mailing Address - Phone:217-342-0304
Mailing Address - Fax:
Practice Address - Street 1:212 E JEFFERSON AVE STE 2
Practice Address - Street 2:
Practice Address - City:EFFINGHAM
Practice Address - State:IL
Practice Address - Zip Code:62401-3458
Practice Address - Country:US
Practice Address - Phone:217-342-0304
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-24
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty