Independent Order of Odd Fellows

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

Legal business name

INDEPENDENT ORDER OF ODD FELLOWS

Doing business as

Odd Fellow Rebekah Home

Practice address

201 Lafayette Ave E
Mattoon, IL 61938-4641

Phone

(217) 235-5449

Fax

(217) 235-0611

NPI assigned

Nov 19, 2012

Last updated

Jan 11, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

David Underwood, CPA

Title

Exec VP, Cfo

Phone

(309) 823-7135

Specialties & licenses 1

Addresses

Other names 1

• Odd Fellow Rebekah Home Doing business as

Tax ID family

Independent Order of Odd Fellows2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Independent Order of Odd Fellows

  dba Odd Fellow Rebekah Home

  • Skilled Nursing Facility
  • Mattoon, IL
  • NPI 1700877545
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1353283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515628800000",
    "number": "1063756799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 W JEFFERSON ST",
            "address_2": "SUITE 401",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013946",
            "telephone_number": "309-828-4361",
            "fax_number": "309-829-5477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 LAFAYETTE AVE E",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619384641",
            "telephone_number": "217-235-5449",
            "fax_number": "217-235-0611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT ORDER OF ODD FELLOWS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-19",
        "last_updated": "2018-01-11",
        "status": "A",
        "authorized_official_last_name": "UNDERWOOD",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "EXEC VP, CFO",
        "authorized_official_telephone_number": "309-823-7135",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Odd Fellow Rebekah Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jillian E Hurt
• Donald Hutton II, RPH.
• Pamela Kay Hutton
• HW Holdings (All About Eyes)
• Illinois Express Vision Center-Mattoon Inc. (Illinois Express Eyecare)
• Independent Order of Odd Fellows (Odd Fellow Rebekah Home)
• Roza Ioffe, M.D.
• Randy R Isaacs, MD
• Shemariah Laish Israel, MD
• Breanna J Jackson, WHNP

• Oxygen Equipment & Supplies (DME) in Mattoon, IL
• Providers in Mattoon, IL by specialty
• Oxygen Equipment & Supplies (DME) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.