Individual provider Active NPI

Michelle Talley, RN

  • Psychiatric/Mental Health Registered Nurse
  • Dekalb, IL
National Provider Identifier
1114168630
Registry record updated Mar 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
041345097 Issued in IL
Practice address
12 Health Services Dr
Dekalb, IL 60115-9637
Phone
(815) 756-4875
Fax
(815) 756-2944
NPI assigned
Mar 12, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 041345097 IL Primary

Addresses

Primary practice location

12 Health Services Dr
Dekalb, IL 60115-9637

Mailing address

12 Health Services Dr
Dekalb, IL 60115-9637
Phone (815) 756-4875

Other names 1

  • Miss Michelle Benad Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
041345097ILMDPsychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1236816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236816000000",
    "number": "1114168630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 HEALTH SERVICES DR",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601159637",
            "telephone_number": "815-756-4875",
            "fax_number": "815-756-2944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 HEALTH SERVICES DR",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601159637",
            "telephone_number": "815-756-4875",
            "fax_number": "815-756-2944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALLEY",
        "first_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-12",
        "last_updated": "2009-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "IL",
            "license": "041345097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "BENAD",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dekalb, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2009; 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.