NPIMap

Organization Active NPI

Neuromonitoring Service LLC

  • Physical Medicine & Rehabilitation Physician
  • Normal, IL
National Provider Identifier
1467583955
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
036-061013 Issued in IL
Legal business name
NEUROMONITORING SERVICE LLC
Practice address
1604 Visa Dr Ste 1
Normal, IL 61761-2195
Phone
(309) 454-1100
NPI assigned
Mar 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Authorized official

Name
Panna U Goswami, MD
Title
Physician Owner
Phone
(309) 846-4716

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X 036-061013 IL Primary

Addresses

Primary practice location

1604 Visa Dr Ste 1
Normal, IL 61761-2195

Mailing address

1604 Visa Dr Ste 1
Normal, IL 61761-2195
Phone (309) 454-1100

National Provider Directory

National Provider Directory

Locations

3002 Gill St
Ste 3
Bloomington, IL 61704
Phone (309) 664-7991

1604 Visa Dr
Ste 1
Normal, IL 61761
Phone (309) 846-4716

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693353600000",
    "number": "1467583955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1604 VISA DR STE 1",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617612195",
            "telephone_number": "309-454-1100",
            "fax_number": "309-218-1415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1604 VISA DR STE 1",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617612195",
            "telephone_number": "309-454-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROMONITORING SERVICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A",
        "authorized_official_last_name": "GOSWAMI",
        "authorized_official_first_name": "PANNA",
        "authorized_official_middle_name": "U",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "309-846-4716",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "036-061013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Normal, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; 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.