Tabitha Mae Theiler, RST, CST

Primary specialty

Surgical TechnologistTaxonomy code 246ZS0410X

License

237000200 Issued in IL

Practice address

5666 E State St
Rockford, IL 61108-2472

Phone

(815) 226-2000

NPI assigned

Mar 16, 2021

Last updated

Mar 16, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1615852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615852800000",
    "number": "1750966115",
    "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": "309-846-4716",
            "fax_number": "309-454-7348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5666 E STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082472",
            "telephone_number": "815-226-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEILER",
        "first_name": "TABITHA",
        "middle_name": "MAE",
        "name_prefix": "Ms.",
        "credential": "RST, CST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-16",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "IL",
            "license": "237000200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Bridge Clinic of Rockofrd
• The Elitist Group
• The Fit Med Experience (Fit Med)
• The Inspiration and Life Enhancement
• The Lotus Center
• Timothy Allen Theisen, DDS, MS
• Theodore S. Ingrassia, III, M.D.S.C.
• Annelise Thifault
• Jennifer Thilges, APRN
• Thinfast MD Rockford

• Surgical Technologist in Rockford, IL
• Providers in Rockford, IL by specialty
• Surgical Technologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2021; 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.