MRS. HEATHER SUE ILLG (NPI# 1952704504) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952704504 |
| Entity Type | Individual |
| Full Name | MRS. HEATHER SUE ILLG |
| Credential | RD LD |
| Practice Address |
8701 Douglas Ave Urbandale IA 50322-2200 |
| Practice Telephone | 5152515284 |
| Practice Fax Number | 5152702227 |
| Mailing Telephone | 5152515284 |
| Mailing Fax Number | 5152702227 |
| Enumeration Date | 2014-09-26 |
| Last Update Date | 2014-09-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 136A00000X | Dietetic Technician, Registered | 01342 | IA | Dietary & Nutritional Service Providers |
| Street Address |
8701 DOUGLAS AVE |
| City | URBANDALE |
| State | IA |
| Zip Code | 50322-2200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659307197 | Hy Vee Inc | Durable Medical Equipment & Medical Supplies | 8701 Douglas Ave, Urbandale, IA 50322-2200 | 2006-06-25 |
| 1629689575 | John Stephan Farris | Pharmacist | 8701 Douglas Ave, Urbandale, IA 50322-2200 | 2020-08-13 |
| 1972122521 | Tracy Nicole Rulli | Pharmacist | 8701 Douglas Ave, Urbandale, IA 50322-2200 | 2020-04-14 |
| 1326667031 | Wendy Sue Klemme | Pharmacist | 8701 Douglas Ave, Urbandale, IA 50322-2299 | 2020-04-13 |
| 1306465398 | Angela White | Pharmacist | 8701 Douglas Ave, Urbandale, IA 50322-2200 | 2020-04-10 |
| 1619596780 | Brooke Nicole Slagle | Pharmacist | 8701 Douglas Ave, Urbandale, IA 50322-2299 | 2020-04-09 |
| 1235468588 | Elizabeth Ann Pohlman | Dietitian, Registered | 8701 Douglas Ave, Urbandale, IA 50322-2200 | 2009-12-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598278434 | Mary Melissa Buchanan | Hospice Care, Community Based | 6101 Goodman Dr, Urbandale, IA 50322 | 2017-11-14 |
| 1932629110 | Kelsey Coaldrake | Speech-Language Pathologist | 2570 106th St Ste E, Urbandale, IA 50322 | 2017-06-20 |
| 1861940207 | Jessalynn Bradley | Home Health Aide | 8704 Meredith Dr., Apt. 208, Urbandale, IA 50322 | 2016-09-14 |
| 1083086862 | Iowa Dermatology Clinic, Plc | Dermatology | 3729 86th St, Urbandale, IA 50322 | 2015-10-20 |
| 1598134686 | Iowa Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 14201 Hickman Rd., Urbandale, IA 50322 | 2015-09-18 |
| 1114303484 | Monique I Elgersma | Marriage & Family Therapist | 3829 71st St Ste A, Urbandale, IA 50322 | 2015-08-10 |
| 1821437922 | Maggie Lynn Leavens | Physical Therapy Assistant | 4614 84th Street, Urbandale, IA 50322 | 2013-06-21 |
| 1225378581 | Nicholas David Burton Lantz | Physical Therapy Assistant | 4614 Nw 84th Street, Urbandale, IA 50322 | 2013-02-25 |
| 1750645826 | Joseph Horn Thompson | Pharmacist | 9616 Quail Ridge, Urbandale, IA 50322 | 2012-07-03 |
| 1437481827 | Community Support Advocates, LLC | Social Worker | 6000 Aurora Avenue, Suite B, Des Moines, IA 50322 | 2010-02-10 |
| Find all providers in zip 50322 | ||||
| Taxonomy Code | 136A00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietetic Technician, Registered |
| A person trained in food and nutrition who is an integral part of health care and foodservice management teams. A dietetic technician, registered (DTR) has successfully completed at least a two-year associate’s degree at a US regionally accredited college or university; a dietetic technician program approved by The American Dietetic Association, including 450 hours of supervised practice experience; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Dietetic Technician, Registered -- a food and nutrition practitioner. Chicago, IL: The American dietetic association, July 1997. |
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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.