Midwest Neuromonitoring, Inc.

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

MIDWEST NEUROMONITORING, INC.

Practice address

1015 S Mercer Ave
Bloomington, IL 61701-7107

Phone

(309) 820-7982

Fax

(309) 820-7982

NPI assigned

Mar 13, 2008

Organization subpart

No

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

Authorized official

Name

Terry McKenna, MS, CNIM

Title

President

Phone

(309) 820-7982

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1205366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205366400000",
    "number": "1831360239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 S MERCER AVE",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617017107",
            "telephone_number": "309-820-7982",
            "fax_number": "309-820-7982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 S MERCER AVE",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617017107",
            "telephone_number": "309-820-7982",
            "fax_number": "309-820-7982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST NEUROMONITORING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-13",
        "last_updated": "2008-03-13",
        "status": "A",
        "authorized_official_last_name": "MCKENNA",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-820-7982",
        "authorized_official_credential": "MS, CNIM"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physiological Laboratory in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Physiological Laboratory in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 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.