Hasselman, Ty E
Hasselman, Ty E is an individual health care provider with primary practice located at 420 Ne Glen Oak Ave Suite 301, Peoria IL 61603-3105. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Cardiology, which is considered as his primary health care specialty. Hasselman, Ty E can be contacted via phone (309) 655-3453.Contact Information
Primary practice address
420 Ne Glen Oak Ave Suite 301
Peoria IL 61603-3105
Phone: (309) 655-3453
Fax: (309) 655-3410
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Cardiology | 2080P0202X | 036-106293 | Illinois |
Profile Details
| NPI number | 1861438434 |
|---|---|
| LBN Legal business name | Hasselman, Ty E |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 21st, 2006 |
| Last updated | Sep 21st, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1861438434 | NPPES |
| Illinois | MEDICAID | 036106293 |
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