Allen Bernard Devleschoward Jr., M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

302 W Hay St
Ste 210
Decatur, IL 62526-4167

Phone

(217) 877-5943

Fax

(217) 877-0023

NPI assigned

Jan 19, 2007

Last updated

Jul 29, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Decatur Neurological Associates LTD.

  • Neurology Physician
  • Decatur, IL
  • NPI 1922128388
  NPD (past)
• Radiological Associates of Decatur

  • Diagnostic Radiology Physician
  • Springfield, IL
  • NPI 1427131127
  NPD (past)

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311897600000",
    "number": "1326191503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 W HAY ST",
            "address_2": "STE 210",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264167",
            "telephone_number": "217-877-5943",
            "fax_number": "217-877-0023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 W HAY ST",
            "address_2": "STE 210",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264167",
            "telephone_number": "217-877-5943",
            "fax_number": "217-877-0023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVLESCHOWARD",
        "first_name": "ALLEN",
        "middle_name": "BERNARD",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2011-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "036045992",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036-045992",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036045992",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dental Professionals of Illinois, P.C. (Long Creek Dental)
• Department of Veterans Affairs
• Mary Anne Depaz, MD
• Marcus S Deranian, M.D.
• Yashvi Falguni Desai
• Devoted Caregivers
• Nakeya Khozema Dewaswala, MD
• Harvinder Dhillon, MD
• Radwan H Diab, M.D.
• Dialysis Centers of America - Illinois, Inc. (RCG Central Illinois-Decatur (Home))

• Specialist in Decatur, IL
• Providers in Decatur, IL by specialty
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.