Prophetstown Lyndon Tampico Cu

Primary specialty

Local Education Agency (LEA)Taxonomy code 251300000X

Legal business name

PROPHETSTOWN LYNDON TAMPICO CU

Practice address

310 W Riverside Dr
Prophetstown, IL 61277-1013

Phone

(815) 622-0858

NPI assigned

Jun 5, 2007

Organization subpart

No

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

Authorized official

Name

Drew Hoffman

Title

Director

Phone

(815) 622-0858

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306048855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 W RIVERSIDE DR",
            "city": "PROPHETSTOWN",
            "state": "IL",
            "postal_code": "612771013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 W RIVERSIDE DR",
            "city": "PROPHETSTOWN",
            "state": "IL",
            "postal_code": "612771013",
            "telephone_number": "815-622-0858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROPHETSTOWN LYNDON TAMPICO CU",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOFFMAN",
        "authorized_official_first_name": "DREW",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "815-622-0858"
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel John Howard, OTR/L
• Tyla Hughes
• Abigail Katherine Lench, D.C.
• Karen Louise Niemi, RPH
• Prophetstown Fire Protection District
• Rock Valley Physical Therapy Center
• Brooke Russell, D.P.T.
• Abigail M Temple, DPT
• The Evangelical Lutheran Good Samaritan Society
• Richa S Vaidya, PHYSICAL THERAPIST

• All providers in Prophetstown, IL
• Local Education Agency (LEA) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.