CENTRAL ILLINOIS NERVE TESTING LTD NPI 1386802775

NPI Information

NPI: 1386802775
Provider Name: CENTRAL ILLINOIS NERVE TESTING LTD
Classification: Podiatrist - 213EP1101X
Entity Type: Organization

Specialization: Primary Podiatric Medicine

Address:
3322 W WILLOW KNOLLS RD
PEORIA, IL
ZIP 61614
Phone: (309) 691-1727
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CENTRAL ILLINOIS NERVE TESTING LTD is a primary podiatric medicine podiatrist in Peoria, IL. CENTRAL ILLINOIS NERVE TESTING LTD NPI is 1386802775. The provider is registered as an organization entity type.

The provider's business location address is:

3322 W WILLOW KNOLLS RD
PEORIA, IL
ZIP 61614-148
Phone: (309) 691-1727
Fax: (309) 637-2325

The provider's authorized official is John D Ruff .
The authorized official title is Dr and has the following contact phone number (309) 691-1727.

The enumeration date for this NPI number is 6/2/2008 and was last updated on 9/19/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	302F00000X	Exclusive Provider Organization		016003701	ILLINOIS	No
2	213EP1101X	Podiatrist	Primary Podiatric Medicine	016003701	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1285613463	OTHER	ILLINOIS	T. KEVIN BRATTAIN, DPM
2	1093885378	OTHER	ILLINOIS	MARK SMITH, DPM
3	1083613293	OTHER	ILLINOIS	ANTHONY V DECEANNE DPM
4	016003701	MEDICARE UPIN	ILLINOIS
5	1114926748	OTHER	ILLINOIS	CURTIS WARD, DPM
6	1015930001	MEDICARE NSC	ILLINOIS
7	742740	MEDICARE PIN	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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