Individual provider Active NPI

Michael J Hourigan, CRNA

  • Registered Nurse
  • Salem, IL
National Provider Identifier
1184686115
Registry record updated Oct 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
041-134876 Issued in IL
Practice address
1201 Ricker Rd
Salem, IL 62881-4263
Phone
(618) 548-3194
Fax
(618) 548-1944
NPI assigned
Apr 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041-134876 IL Primary

Addresses

Primary practice location

1201 Ricker Rd
Salem, IL 62881-4263

Mailing address

4621 CJ Heck Rd
Salem, IL 62881-3727
Phone (618) 548-3031

Other identifiers 1

IdentifierTypeStateIssuer
209-000257OtherILADVANCED PRACTICE NURSE

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)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
041-134876ILMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319414400000",
    "number": "1184686115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4621 CJ HECK RD",
            "city": "SALEM",
            "state": "IL",
            "postal_code": "628813727",
            "telephone_number": "618-548-3031",
            "fax_number": "618-548-0596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 RICKER RD",
            "city": "SALEM",
            "state": "IL",
            "postal_code": "628814263",
            "telephone_number": "618-548-3194",
            "fax_number": "618-548-1944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOURIGAN",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2011-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041-134876",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANCED PRACTICE NURSE",
            "identifier": "209-000257",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2011; 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.