Active NPI
Monique Rynties
- Physician Assistant
- Bloomington, IL
National Provider Identifier
1447599071
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 085-004582
- Practice address
- 1505 Eastland Drive
Bloomington, IL 61701-7905 - Phone
- (309) 663-2100
- Fax
- (309) 663-8322
- NPI assigned
- Feb 1, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 085-004582 | IL | Primary |
Addresses
Primary practice location
1505 Eastland Drive
Bloomington, IL 61701-7905
Mailing address
1505 Eastland Drive
Bloomington, IL 61701-7905
Phone (309) 663-2100
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085-004582 | IL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rosalind Franklin University Health | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Durable Medical Equipment & Medical Supplies
- North Chicago, IL
- NPI 1982894911
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1359676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359676800000",
"number": "1447599071",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1505 EASTLAND DRIVE",
"city": "BLOOMINGTON",
"state": "IL",
"postal_code": "617017905",
"telephone_number": "309-663-2100",
"fax_number": "309-663-8322"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1505 EASTLAND DRIVE",
"city": "BLOOMINGTON",
"state": "IL",
"postal_code": "617017905",
"telephone_number": "309-663-2100",
"fax_number": "309-663-8322"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RYNTIES",
"first_name": "MONIQUE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-02-01",
"last_updated": "2013-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IL",
"license": "085-004582",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.