BLOOMINGTON NORMAL HEALTHCARE LLC NPI 1083613327

NPI Information

  • NPI: 1083613327
  • Provider Name: BLOOMINGTON NORMAL HEALTHCARE, LLC
  • Classification: Clinic/Center - 261QA1903X
  • Specialization: Ambulatory Surgical
  • Entity Type: Organization
  • CLIA Number: 14D0991589
  • Address: 2100 FORT JESSE RD
    NORMAL, IL
    ZIP 61761
  • Phone: (309) 834-4000

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NPI Details

BLOOMINGTON NORMAL HEALTHCARE, LLC is an ambulatory surgical clinic center in Normal, IL. BLOOMINGTON NORMAL HEALTHCARE, LLC NPI is 1083613327. The provider is registered as an organization entity type.

The provider's business location address is:

2100 FORT JESSE RD
NORMAL, IL
ZIP 61761-370
Phone: (309) 834-4000
Fax: (309) 834-4007

The provider's authorized official is Thomas B Kulb .
The authorized official title is Physician/owner and has the following contact phone number (309) 834-4000.

The CLIA number assigned to this NPI record is 14D0991589 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Injection, onabotulinumtoxina, 1 unit (HCPCS:J0585)
  • Insertion of stent in ureter using an endoscope (HCPCS:52332)
  • Imaging of urinary tract following injection of a contrast agent (HCPCS:74420)
  • Crushing of stone of ureter with insertion of stent using an endoscope (HCPCS:52356)
  • Complete laser vaporization of prostate including control of bleeding using an endoscope (HCPCS:52648)
  • Correction of toe joint deformity (HCPCS:28285)
  • Biopsy of bladder using an endoscope (HCPCS:52204)
  • Exam with injections of chemical for destruction of bladder using an endoscope (HCPCS:52287)
  • Diagnostic exam of bladder and urethra using an endoscope (HCPCS:52000)
  • Release and/or relocation of hand nerve (HCPCS:64721)

The enumeration date for this NPI number is 7/19/2005 and was last updated on 8/22/2020.

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
1261QA1903XClinic/CenterAmbulatory Surgical7002512ILLINOISYes

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
150181OTHERILLINOISBCBS

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: 11/21/2025

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