Contemporary Obstetrics & Gynecology PC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

CONTEMPORARY OBSTETRICS & GYNECOLOGY PC

Practice address

2304 Stern Dr
Bloomington, IL 61704-4487

Phone

(309) 663-0411

Fax

(309) 662-2018

NPI assigned

Aug 30, 2007

Organization subpart

No

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

Authorized official

Name

Heather L Dudley, D.O.

Title

President

Phone

(309) 663-0411

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• CONTEMPORARY OB/GYN Other name

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

{
    "created_epoch": "1188432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205798400000",
    "number": "1164616389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2304 STERN DR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617044487",
            "telephone_number": "309-663-0411",
            "fax_number": "309-662-2018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2304 STERN DR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617044487",
            "telephone_number": "309-663-0411",
            "fax_number": "309-662-2018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONTEMPORARY OBSTETRICS & GYNECOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-30",
        "last_updated": "2008-03-18",
        "status": "A",
        "authorized_official_last_name": "DUDLEY",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-663-0411",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "5732148",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "216064",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CONTEMPORARY OB/GYN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Obstetrics & Gynecology Physician in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Obstetrics & Gynecology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.