ALLEN BERNARD DEVLESCHOWARD JR. (NPI# 1326191503) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326191503 |
| Entity Type | Individual |
| Full Name | ALLEN BERNARD DEVLESCHOWARD JR. |
| Credential | M.D. |
| Practice Address |
302 W Hay St Ste 210 Decatur IL 62526-4167 |
| Practice Telephone | 2178775943 |
| Practice Fax Number | 2178770023 |
| Mailing Telephone | 2178775943 |
| Mailing Fax Number | 2178770023 |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2011-07-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | IL | Other Service Providers | |
| N | 174400000X | Specialist | 036045992 | IL | Other Service Providers |
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
036-045992 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036045992 | 05 |
| Street Address |
302 W HAY ST STE 210 |
| City | DECATUR |
| State | IL |
| Zip Code | 62526-4167 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063411304 | Lee G Endsley | Urology | 302 W Hay St, Ste 200, Decatur, IL 62526-4167 | 2005-07-19 |
| 1073969044 | Nicole Suzette Soper | Registered Nurse | 302 W Hay St, Decatur, IL 62526-4167 | 2016-05-10 |
| 1629490628 | John W. Newlin, M.d., LLC | Internal Medicine | 302 W Hay St, Suite 130, Decatur, IL 62526-4167 | 2014-01-09 |
| 1811322001 | Sneha Kumar | Family Medicine | 302 W Hay St, Suite 110, Decatur, IL 62526-4167 | 2013-09-06 |
| 1104196294 | Jeremy Good | Physician Assistant | 302 W Hay St, Suite 200, Decatur, IL 62526-4167 | 2012-01-05 |
| 1255587176 | Midwest Neurology Associates, S.c. | Specialist | 302 W Hay St, Suite Ll110, Decatur, IL 62526-4167 | 2008-08-12 |
| 1699962209 | Steven E Weber, Md, Ltd | Surgery | 302 W Hay St, Suite 205, Decatur, IL 62526-4167 | 2007-09-27 |
| 1376737346 | Sudhakar Konda | Family Medicine | 302 W Hay St, Lower Level Suite 110, Decatur, IL 62526-6304 | 2007-08-31 |
| 1942333067 | Midwest Neurology Associates, S.c. | Specialist | 302 W Hay St, Suite Ll110, Decatur, IL 62526-4167 | 2007-03-14 |
| 1528164951 | George Albert Liu | Surgery | 302 W Hay St, Ste 205, Decatur, IL 62526-4167 | 2006-09-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083100804 | Coalition | Non-emergency Medical Transport (VAN) | 2375 N Longwood Dr, Decatur, IL 62526 | 2018-07-04 |
| 1881116820 | Bria N Howard | Nurse's Aide | 606 E Warren St. Apt 609, Decatur, IL 62526 | 2017-07-12 |
| 1437683679 | Lutheran Child and Family Services | Foster Care Agency | 2826 N. Monroe Street, Decatur, IL 62526 | 2017-04-14 |
| 1083166326 | Whitney Miller | Pharmacist | 225 East Ash Ave, Decatur, IL 62526 | 2016-11-03 |
| 1487053369 | Central Illinois Health Associates, Inc | Preferred Provider Organization | 2300 N. Edward Street, Decatur, IL 62526 | 2014-08-18 |
| 1659787893 | Stephanie Marie Kanitsch | Obstetrics & Gynecology | 544 W Pershing Rd Ste A, Decatur, IL 62526 | 2014-07-09 |
| 1497169973 | Brian Hassinger | Audiologist-Hearing Aid Fitter | 2605 N Water St Ste 101, Decatur, IL 62526 | 2014-06-12 |
| 1891041570 | Decatur 2016 LLC | Dentist | 141 Epershing Rd, Decatur, IL 62526 | 2012-07-31 |
| 1558639005 | Larry Lee Christensen | Pharmacist | 225 Ash Ave, Decatur, IL 62526 | 2011-12-12 |
| 1174821540 | Nathan Pyle | Internal Medicine | 2 Memorial Dr Ste 101, Decatur, IL 62526 | 2011-03-08 |
| Find all providers in zip 62526 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
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| 1033660345 | Sabra Services LLC | Specialist | 726 County Road 3250, Decatur, TX 76234-4857 | 2016-10-21 |
| 1154874758 | Erica Nicole West | Specialist | 3446 Newberry Trl, Decatur, GA 30034-3248 | 2016-07-31 |
| 1639552649 | Supreme Healthcare Ob/gyn LLC | Specialist | 5536 Flat Shoals Pkwy, Suite A, Decatur, GA 30034-5408 | 2015-07-08 |
| 1427474766 | Russell Clinding | Specialist | 5036 Snapfinger Woods Dr Ste 217, Decatur, GA 30035-4047 | 2014-03-11 |
| 1598013831 | Total Health Pain Center | Specialist | 4150 Snapfinger Way, Suite 102, Decatur, GA 30035-2711 | 2012-08-16 |
| 1841420510 | Deborah Tawil | Specialist | 118 Barry St, Decatur, GA 30030-3465 | 2009-07-16 |
| 1396973665 | Wanda Denise Nelson | Specialist | 3275 Creekway Ln, Decatur, GA 30034-4909 | 2009-06-25 |
| 1053588731 | David Douglas Shepard | Specialist | 2675 N Decatur Rd Ste 200, Decatur, GA 30033-6132 | 2008-05-13 |
| Find all providers in DECATUR | ||||
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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.