Midwest Neurofitness

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180-002663 Issued in IL

Legal business name

MIDWEST NEUROFITNESS

Practice address

313 N Mattis Ave
Suite 205
Champaign, IL 61821-2460

Phone

(217) 348-1086

Fax

(217) 355-4012

NPI assigned

Mar 10, 2007

Last updated

Jul 7, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. William Andrew Hogan, PHDNPI 1093847592

Title

Majority Partner

Phone

(217) 348-1086

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• William Andrew Hogan, PHD

  • Professional Counselor
  • Champaign, IL
  • NPI 1093847592
  NPD (past) Authorized official

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

{
    "created_epoch": "1173484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215388800000",
    "number": "1447382932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 584",
            "city": "CHARLESTON",
            "state": "IL",
            "postal_code": "619200584",
            "telephone_number": "217-348-1086",
            "fax_number": "217-355-4012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 N MATTIS AVE",
            "address_2": "SUITE 205",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618212460",
            "telephone_number": "217-348-1086",
            "fax_number": "217-355-4012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST NEUROFITNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-10",
        "last_updated": "2008-07-07",
        "status": "A",
        "authorized_official_last_name": "HOGAN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "MAJORITY PARTNER",
        "authorized_official_telephone_number": "217-348-1086",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180-002663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "01532018",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rick C Meyer, B.A.
• Sara Jo Meyer, O.D.
• Michael Muscatella LTD (Family Foot & Ankle Center of champaign)
• Michael Shmikler Counseling LLC
• Jeanie Mickelsen, LCPC
• Midwest Spine and Regenerative Pain Center Inc
• Midwest Surgical Center
• Rachel Miebach
• Anne Mikalik, RN
• Ian Miles, RBT

• Professional Counselor in Champaign, IL
• Providers in Champaign, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.