MR. HESTON J ALLRED (NPI# 1063012789) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063012789 |
| Entity Type | Individual |
| Full Name | MR. HESTON J ALLRED |
| Practice Address |
1604 Visa Dr Ste 1 Normal IL 61761-2195 |
| Practice Telephone | 3098464716 |
| Practice Fax Number | 3094547348 |
| Mailing Telephone | 3098464716 |
| Mailing Fax Number | 3094547348 |
| Enumeration Date | 2020-10-30 |
| Last Update Date | 2020-10-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246ZE0600X |
Specialist/Technologist, Other Specialization: Electroneurodiagnostic |
Technologists, Technicians & Other Technical Service Providers |
| Street Address |
1604 VISA DR STE 1 |
| City | NORMAL |
| State | IL |
| Zip Code | 61761-2195 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467583955 | Neuromonitoring Service LLC | Physical Medicine & Rehabilitation | 1604 Visa Dr Ste 1, Normal, IL 61761-2195 | 2007-03-08 |
| 1821607284 | Korine M Tatroe | Specialist/Technologist, Other | 1604 Visa Dr Ste 1, Normal, IL 61761-2195 | 2020-07-30 |
| 1154961092 | Desiree A Padilla | Specialist/Technologist, Other | 1604 Visa Dr Ste 1, Normal, IL 61761-2195 | 2020-01-08 |
| 1538714191 | Douglas S Holt | Specialist/Technologist, Other | 1604 Visa Dr Ste 1, Normal, IL 61761-2195 | 2019-08-09 |
| 1942746185 | Marlon Pemberton | Spec/Tech, Pathology | 1604 Visa Dr Ste 1, Normal, IL 61761-2195 | 2017-01-11 |
| 1316204266 | Sidney E Kessinger | Specialist/Technologist, Other | 1604 Visa Dr Ste 1, Normal, IL 61761-2195 | 2012-04-17 |
| 1962706275 | Shawna Summers | Specialist/Technologist, Other | 1604 Visa Dr Ste 1, Normal, IL 61761-2195 | 2010-12-29 |
| 1639471113 | Stephanie Sprague | Specialist/Technologist, Other | 1604 Visa Dr Ste 1, Normal, IL 61761-2195 | 2010-12-03 |
| 1194958330 | Julie L Dieterman | Registered Nurse | 1604 Visa Dr Ste 1, Normal, IL 61761-2195 | 2009-09-03 |
| 1740414648 | Rosalie Ann Reason | Specialist/Technologist, Other | 1604 Visa Dr Ste 1, Normal, IL 61761-2195 | 2009-05-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629681796 | Brittany Nicole Mekley | Nurse Practitioner | 201 N. University, Normal, IL 61761 | 2020-08-28 |
| 1679108971 | Krystal Halliday | Occupational Therapist | 1815 N Towanda Barnes Rd, Normal, IL 61761 | 2020-03-06 |
| 1265915474 | Laine E Burek | Nurse Practitioner | 1765 Bradford Ln., Normal, IL 61761 | 2018-09-13 |
| 1801389986 | Ashley Michelle James | Specialist/Technologist | 347 S. University St, Normal, IL 61761 | 2018-06-12 |
| 1447750708 | Shelley R. Ruch | Specialist/Technologist, Other | 1604 Visa Drive, Ste 1, Normal, IL 61761 | 2018-02-13 |
| 1497275069 | Mclean County Nursing Home | Non-emergency Medical Transport (VAN) | 901 N. Main St, Normal, IL 61761 | 2017-06-23 |
| 1235673666 | Megan Threm | Registered Nurse | 900 Franklin Ave Community Health Care Clinic, Normal, IL 61761 | 2016-12-04 |
| 1437513553 | Tiesha Smith | Specialist | 1800 Rockingham Dr, Apt 1d, Normal, IL 61761 | 2016-04-06 |
| 1285031658 | New Day Recovery | Community/Behavioral Health | 402 Summit, Normal, IL 61761 | 2014-12-01 |
| 1174927701 | Alyssa Marie Bruck | Occupational Therapist | 700 N Walnut St, Normal, IL 61761 | 2014-10-10 |
| Find all providers in zip 61761 | ||||
| Taxonomy Code | 246ZE0600X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Specialist/Technologist, Other |
| Specialization | Electroneurodiagnostic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629468541 | Definitive Neurodiagnostics, LLC Professional Services | Specialist/Technologist, Other | 1604 Visa Dr # 1, Normal, IL 61761-2195 | 2015-01-30 |
| 1659490761 | Definitive Neurodiagnostics LLC | Specialist/Technologist, Other | 1604 Visa Dr, Suite 1, Normal, IL 61761-2195 | 2007-03-28 |
| 1821607284 | Korine M Tatroe | Specialist/Technologist, Other | 1604 Visa Dr Ste 1, Normal, IL 61761-2195 | 2020-07-30 |
| 1154961092 | Desiree A Padilla | Specialist/Technologist, Other | 1604 Visa Dr Ste 1, Normal, IL 61761-2195 | 2020-01-08 |
| 1295281228 | Brenna Catherine Maxine Knott | Specialist/Technologist, Other | 1604 Visa Dr, Normal, IL 61761-2195 | 2016-08-30 |
| 1467830869 | Deborah Berryman | Specialist/Technologist, Other | 1604 Visa Dr, Suite 1, Normal, IL 61761-2195 | 2015-05-18 |
| 1184002578 | Susan Ribordy | Specialist/Technologist, Other | 1604 Visa Dr, Suite 1, Normal, IL 61761-2195 | 2015-05-18 |
| 1134519051 | Definitive Neurodiagnostics, LLC Technical Services | Specialist/Technologist, Other | 1604 Visa Dr # 1, Normal, IL 61761-2195 | 2015-01-30 |
| 1740610252 | Alan Levy | Specialist/Technologist, Other | 1604 Visa Dr., Ste. 1, Normal, IL 61761 | 2013-11-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437761525 | Rick D Hitchens | Specialist/Technologist, Other | 676 Framingham Ct, Gurnee, IL 60031-3496 | 2020-08-19 |
| 1740824986 | Samuel Montes | Specialist/Technologist, Other | 4014 N Spaulding Ave Apt G, Chicago, IL 60618-3328 | 2019-10-31 |
| 1588225635 | Ramon Edgargo Nunez | Specialist/Technologist, Other | 205 Lake St, Libertyville, IL 60048-1850 | 2019-06-27 |
| 1477069946 | Melissa Costello-mckee | Specialist/Technologist, Other | 6003 Jackpine Rd, Bloomington, IL 61705-7502 | 2017-12-20 |
| 1720500580 | Uche Michael Esedebe | Specialist/Technologist, Other | 5013 Florence Ave Apt 3, Downers Grove, IL 60515-3973 | 2017-07-13 |
| 1396107918 | Darla Schwertfeger | Specialist/Technologist, Other | 2104 Hedgewood Dr, Bloomington, IL 61704 | 2016-03-23 |
| 1942569843 | Intranerve LLC | Specialist/Technologist, Other | 2210 Abbeywood Dr Ste A, Lisle, IL 60532-3384 | 2012-05-11 |
| 1922308220 | Sandie Dragos | Specialist/Technologist, Other | 3905 Crosby St, Rockford, IL 61107-4865 | 2010-11-02 |
| 1265732036 | Rockford Neuromonitoring Group LLC | Specialist/Technologist, Other | 1036 Lundvall Ave, Rockford, IL 61107-3338 | 2010-10-27 |
| 1780908434 | Chicago Electrical Trauma Research Institute | Specialist/Technologist, Other | 4047 W. 40th Street, Chicago, IL 60632 | 2010-03-24 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.