ILA MAE MINNICK (NPI# 1134240989) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134240989 |
| Entity Type | Individual |
| Full Name | ILA MAE MINNICK |
| Other Name | ILA MAE ETHELL |
| Practice Address |
7604 Bridlewood Rd Caledonia IL 61011-9013 |
| Practice Telephone | 8158851195 |
| Mailing Telephone | 8158851195 |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WA2000X |
Registered Nurse Specialization: Administrator |
IL | Nursing Service Providers |
| Street Address |
7604 BRIDLEWOOD RD |
| City | CALEDONIA |
| State | IL |
| Zip Code | 61011-9013 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467099259 | Scott Laubenstein | Behavior Technician | 5039 Vail Dr, Caledonia, IL 61011-9005 | 2019-11-29 |
| 1760807937 | Kaitlin Adams | Specialist/Technologist | 7580 Bridlewood Rd, Caledonia, IL 61011-9013 | 2014-02-25 |
| 1609395482 | Emily Nicole Cork | Speech-Language Pathologist | 2311 Randolph St, Caledonia, IL 61011-9321 | 2017-09-13 |
| 1508372871 | Lisa Dejong | Psychologist | 2311 Randolph St, Caledonia, IL 61011-9321 | 2017-12-21 |
| 1255420428 | Larry J Kelley | Social Worker | 6450 Blyth Rd, Caledonia, IL 61011-9644 | 2006-10-12 |
| 1023426319 | Rebecca Murphy | Developmental Therapist | 5460 Winners Cir, Caledonia, IL 61011-9694 | 2014-07-30 |
| 1306215835 | Grant Panzella | Specialist/Technologist | 11917 Lerwick Rd, Caledonia, IL 61011-9781 | 2015-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255930962 | Benjamin Foddrill | Specialist/Technologist | 7380 Clearview Dr, Caledonia, MI 49316-9309 | 2020-10-22 |
| 1972115251 | Transformative Counseling Services | Psychologist | 8965 Lenter Dr Se, Caledonia, MI 49316-7793 | 2020-08-19 |
| 1457960080 | Barbara Stacy | Speech-Language Pathologist | 7010 Glen Creek Dr Se, Caledonia, MI 49316-7903 | 2020-07-29 |
| 1881203990 | West Michigan Dental Professionals | Clinic/Center | 6477 Cherry Meadow Dr Se Ste 1, Caledonia, MI 49316-7351 | 2020-07-24 |
| 1881214518 | Advanced Telepractice Enterprises, LLC | Speech-Language Pathologist | 5104 76th St Se, Caledonia, MI 49316-7913 | 2020-04-22 |
| 1083249155 | Goggin Boarding Home, LLC | Custodial Care Facility | 620 Country Road 40, Caledonia, MO 63631 | 2020-03-09 |
| 1477185478 | Andrew Tyler Schohl | Behavior Technician | 6875 Kalamazoo Ave Se, Caledonia, MI 49316-8950 | 2020-02-07 |
| 1467099259 | Scott Laubenstein | Behavior Technician | 5039 Vail Dr, Caledonia, IL 61011-9005 | 2019-11-29 |
| 1851941686 | Gloria Evelan Schroeder | Technician | 117 N 1st Street, Caledonia, MN 55921 | 2019-09-13 |
| 1134783905 | Pam N Taylor | Home Health Aide | 537 Round Lake Dr, Caledonia, MI 49316-9225 | 2019-04-27 |
| Find all providers in CALEDONIA | ||||
| Taxonomy Code | 163WA2000X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Administrator |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992277347 | Superior Nursing Services LLC | Registered Nurse | 8852 N. Milwaukee Ave, Niles, IL 60714 | 2018-12-26 |
| 1255811964 | Charles Robert Sanders | Registered Nurse | 118 Timber Trl, Carterville, IL 62918-2377 | 2018-08-21 |
| 1134646771 | Julianne M. Goudzwaard | Registered Nurse | 841 Buckboard Drive, New Lenox, IL 60451 | 2017-08-24 |
| 1245587898 | Mary Beth Wertz | Registered Nurse | 100 N Jeffery Street, Kankakee, IL 60901 | 2012-08-13 |
| 1396978441 | Karen Kelly | Registered Nurse | Campus Box 1066, Southern Illinois University Edwardsville, Edwardsville, IL 62026-1066 | 2009-08-24 |
| 1447490305 | Marc Emile Hallez | Registered Nurse | 1630 W Congress Parkway, Rush Health Associates, Chicago, IL 60612 | 2009-03-04 |
| 1205001641 | Linda F Samson | Registered Nurse | 20676 Francisca Way, Frankfort, IL 60423-3126 | 2008-04-28 |
| 1255504155 | Joyce N Onyenso | Registered Nurse | 1037 Monterey Ct, University Park, IL 60466 | 2008-04-11 |
| 1043491210 | Barbara Ann Finnie | Registered Nurse | 400 South Main Cross Street, Galatia, IL 62935 | 2007-11-16 |
| 1457564874 | Susan Marie Quillin | Registered Nurse | The Association for Individual Development (aid), 309 New Indian Trail Court, Aurora, IL 60506-2494 | 2007-05-08 |
| Find all providers with the same taxonomy | ||||
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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.