NPIMap

Organization Active NPI

Intranerve LLC

  • Electroneurodiagnostic Specialist/Technologist
  • Lisle, IL
National Provider Identifier
1942569843
Registry record updated May 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Electroneurodiagnostic Specialist/TechnologistTaxonomy code 246ZE0600X
License
246ZE0600X Issued in IL
Legal business name
INTRANERVE LLC
Practice address
2210 Abbeywood Dr Ste a
Lisle, IL 60532-3384
Phone
(331) 330-3336
NPI assigned
May 11, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2012

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

Authorized official

Name
Michael L. Kostreva, BS CNIM
Title
Dir. of Operatons Midwest.
Phone
(331) 330-3336

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Electroneurodiagnostic Specialist/TechnologistGroup: 193400000X SINGLE SPECIALTY GROUP 246ZE0600X 246ZE0600X IL Primary

Addresses

Primary practice location

2210 Abbeywood Dr Ste a
Lisle, IL 60532-3384

Mailing address

2210 Abbeywood Dr Ste a
Lisle, IL 60532-3384
Phone (331) 330-3336

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1336694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336694400000",
    "number": "1942569843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 ABBEYWOOD DR STE A",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605323384",
            "telephone_number": "331-330-3336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 ABBEYWOOD DR STE A",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605323384",
            "telephone_number": "331-330-3336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTRANERVE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-11",
        "last_updated": "2012-05-11",
        "status": "A",
        "authorized_official_last_name": "KOSTREVA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "DIR. OF OPERATONS MIDWEST.",
        "authorized_official_telephone_number": "331-330-3336",
        "authorized_official_credential": "BS CNIM"
    },
    "taxonomies": [
        {
            "code": "246ZE0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
            "state": "IL",
            "license": "246ZE0600X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lisle, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2012; 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.