Organization Active NPI

David M. Skillrud MD LTD.

  • Pulmonary Disease Physician
  • Morton, IL
National Provider Identifier
1366514481
Registry record updated Apr 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
DAVID M. SKILLRUD MD LTD.
Practice address
652 W Jackson St
Morton, IL 61550-1536
Phone
(309) 266-8880
Fax
(309) 266-8889
NPI assigned
Nov 14, 2006
Last updated
Apr 16, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2008

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

Authorized official

Name
Mrs. Lori Best
Title
Office Manager
Phone
(309) 266-8880

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X Primary

Addresses

Primary practice location

652 W Jackson St
Morton, IL 61550-1536

Mailing address

652 W Jackson St
Morton, IL 61550-1536
Phone (309) 266-8880

Other identifiers 2

IdentifierTypeStateIssuer
005145OtherILHEALTH ALLIANCE
0005732063OtherILBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

652 W Jackson St
Morton, IL 61550
Phone (309) 266-8880

1300 Franklin Ave
Ste 340
Normal, IL 61761
Phone (309) 451-9500

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208304000000",
    "number": "1366514481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "652 W JACKSON ST",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615501536",
            "telephone_number": "309-266-8880",
            "fax_number": "309-266-8889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "652 W JACKSON ST",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615501536",
            "telephone_number": "309-266-8880",
            "fax_number": "309-266-8889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID M. SKILLRUD MD LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2008-04-16",
        "status": "A",
        "authorized_official_last_name": "BEST",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "309-266-8880",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "005145",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0005732063",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 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.