Bloomington Normal Ear Nose Throat LTD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

Legal business name

BLOOMINGTON NORMAL EAR NOSE THROAT LTD

Practice address

1404 Eastland Dr Ste 209
Bloomington, IL 61701-7904

Phone

(306) 662-3277

Fax

(309) 663-0845

NPI assigned

Aug 31, 2006

Last updated

Apr 20, 2008By 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

Ann Klimkewicz

Title

Office Manager

Phone

(309) 662-3277

Specialties & licenses 4

Addresses

Other identifiers 3

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lisa Baer

  • Audiologist-Hearing Aid Fitter
  • Bloomington, IL
  • NPI 1083626485
  NPD (past)
• Thomas C Ocheltree, M.D.

  • Otolaryngology Physician
  • Bloomington, IL
  • NPI 1326050881
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1114038528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1404 EASTLAND DR STE 209",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617017904",
            "telephone_number": "306-662-3277",
            "fax_number": "309-663-0845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 EASTLAND DR STE 209",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617017904",
            "telephone_number": "306-662-3277",
            "fax_number": "309-663-0845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOMINGTON NORMAL EAR NOSE THROAT LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "KLIMKEWICZ",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "309-662-3277"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS AUDIOLOGY",
            "identifier": "05732023",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "05700224",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AUDIOLOGY",
            "identifier": "330606647-001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bloomington Medical Distribution LLC
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• Bloomington Normal Audiology
• Bloomington Normal Birthing Center
• Bloomington Normal Birthing Center
• Bloomington Pediatric Speech Therapy LLC
• Bloomington Pediatrics and Allergy LTD
• Bloomington Primary Care, LTD.
• Bloomington Public Schools District87
• Bloomington Rehabilitation Associates, LLC

• Otolaryngology Physician in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Otolaryngology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.