Active NPI
Logan Hayes Weatherford, NEURPHYSIOLOGIST
- Surgical Physician Assistant
- Mokena, IL
National Provider Identifier
1205548864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 238.010990
- Practice address
- 18761 Chestnut CT
Mokena, IL 60448-9501 - Phone
- (786) 448-9020
- NPI assigned
- Dec 14, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 238.010990 | IL | Primary |
| Surgical Assistant | 246ZC0007X | 238.010990 | IL | |
| Electroneurodiagnostic Specialist/Technologist | 246ZE0600X |
Addresses
Primary practice location
18761 Chestnut CT
Mokena, IL 60448-9501
Mailing address
7455 W Washington Ave Ste 302
Las Vegas, NV 89128-4340
Phone (217) 649-6664
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26-237 | IL | MD | Surgical Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Monitoring Associates LLC | Single Specialty | Past | Accepting new patients |
| Proassisting, Inc | Surgical Assistant | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Electrodiagnostic Medicine Physician
- Las Vegas, NV
- NPI 1174916522
Single Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1670976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782259200000",
"number": "1205548864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7455 W WASHINGTON AVE STE 302",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891284340",
"telephone_number": "217-649-6664"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18761 CHESTNUT CT",
"city": "MOKENA",
"state": "IL",
"postal_code": "604489501",
"telephone_number": "786-448-9020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEATHERFORD",
"first_name": "LOGAN",
"middle_name": "HAYES",
"name_prefix": "Mr.",
"credential": "NEURPHYSIOLOGIST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-12-14",
"last_updated": "2026-06-24",
"certification_date": "2026-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "IL",
"license": "238.010990",
"primary": true
},
{
"code": "246ZC0007X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "IL",
"license": "238.010990",
"primary": false
},
{
"code": "246ZE0600X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mokena, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.