Provider Type Icon

BLOOMINGTON PEDIATRICS AND ALLERGY LTD NPI 1053506352


NPI Information

NPI: 1053506352
Provider Name: BLOOMINGTON PEDIATRICS AND ALLERGY LTD
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
306 SAINT JOSEPH DR
BLOOMINGTON, IL
ZIP 61701
Phone: (309) 663-2354
Get Directions

BLOOMINGTON PEDIATRICS AND ALLERGY LTD is a specialist in Bloomington, IL. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. BLOOMINGTON PEDIATRICS AND ALLERGY LTD NPI is 1053506352. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

306 SAINT JOSEPH DR
BLOOMINGTON, IL
ZIP 61701-506
Phone: (309) 663-2354
Fax: (309) 662-8602

The provider's authorized official is Susan Lynne Labounty .
The authorized official title is Office Manager and has the following contact phone number (309) 663-2354.

The enumeration date for this NPI number is 9/10/2007 and was last updated on 3/27/2009.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialist036058820ILLINOISYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1036090475MEDICAIDILLINOIS
2036097491MEDICAIDILLINOIS
3036058820MEDICAIDILLINOIS
4036060449MEDICAIDILLINOIS
5036115725MEDICAIDILLINOIS
6036078523MEDICAIDILLINOIS
7036075395MEDICAIDILLINOIS
8036094964MEDICAIDILLINOIS

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.