DEIRDRE STOUT (NPI# 1811002041) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811002041 |
| Entity Type | Individual |
| Full Name | DEIRDRE STOUT |
| Credential | RN,BS |
| Practice Address |
905 E Main St Olney IL 62450-2623 |
| Practice Telephone | 6183937732 |
| Practice Fax Number | 6183953123 |
| Mailing Telephone | 6183937732 |
| Mailing Fax Number | 6183953123 |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2013-07-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WP0200X |
Registered Nurse Specialization: Pediatrics |
41164518 | IL | Nursing Service Providers |
| N | 222Q00000X | Developmental Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUECROSS/BLUESHIELD IL | 8030288 | 01 |
| Street Address |
905 E MAIN ST |
| City | OLNEY |
| State | IL |
| Zip Code | 62450-2623 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821531849 | Jamie Leigh Burgener | Developmental Therapist | 905 E Main St, Olney, IL 62450-2623 | 2016-11-22 |
| 1205214855 | Lindsay Overton | Developmental Therapist | 905 E Main St, Olney, IL 62450-2623 | 2015-05-15 |
| 1285979971 | Julie N Auteberry | Developmental Therapist | 905 E Main St, Olney, IL 62450-2623 | 2012-12-06 |
| 1669739140 | Megan Allen | Developmental Therapist | 905 E Main St, Olney, IL 62450-2623 | 2012-04-20 |
| 1699063826 | Debra K Coad | Physical Therapist | 905 E Main St, Olney, IL 62450-2623 | 2011-07-21 |
| 1295036275 | Hollie A Kelly | Registered Nurse | 905 E Main St, Olney, IL 62450-2623 | 2010-11-08 |
| 1548412521 | Ashley Bussard | Developmental Therapist | 905 E Main St, Olney, IL 62450-2623 | 2008-10-21 |
| 1942466925 | Rachel Leeann Yockey | Speech-Language Pathologist | 905 E Main St, Olney, IL 62450-2623 | 2008-07-30 |
| 1912170820 | Terri L Newton | Speech-Language Pathologist | 905 E Main St, Olney, IL 62450-2623 | 2008-04-11 |
| 1740467133 | Julia Ann Stover | Case Manager/Care Coordinator | 905 E Main St, Olney, IL 62450-2623 | 2008-01-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851530091 | Donna Harris | Counselor | 515 West St. John Street, Olney, IL 62450 | 2009-02-11 |
| 1942476908 | Christa Dawn Jennette | Private Vehicle | 1113 Keiffer Dr, Olney, IL 62450 | 2008-04-30 |
| 1942491162 | Marion County Horizon Center D/b/a Richland Manor | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1066 West Main St, Olney, IL 62450 | 2007-08-05 |
| 1811100407 | Advanced Open Mri, Inc. | Clinic/Center | 605 East Main Street, Olney, IL 62450 | 2007-05-08 |
| 1548489958 | Frank Edward Gruber | Dentist | 1108 N East St, Olney, IL 62450 | 2007-04-24 |
| 1508084591 | Melvin Borja Escalona | Physical Therapist | 800 East Locust St., Olney, IL 62450 | 2007-04-23 |
| 1881769826 | Jeffrey Alan Kocher | Chiropractor | 731 S West St, Olney, IL 62450 | 2006-11-22 |
| 1336211523 | Patricia Lynn Kessler Bookhout | Dentist | 1104 North East, Olney, IL 62450 | 2006-11-14 |
| 1639159015 | Bowers Drug Store Inc | Pharmacy | 205 E Main, Olney, IL 62450 | 2006-01-20 |
| 1336137199 | South Eastern Illinois Counseling Center Inc | Counselor | 504 Micah Drive, Drawer M, Olney, IL 62450 | 2005-10-06 |
| Find all providers in zip 62450 | ||||
| Taxonomy Code | 163WP0200X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154436384 | Vicki Shawver | Registered Nurse | 723 E Main St, Olney, IL 62450-2619 | 2006-08-20 |
| 1295036275 | Hollie A Kelly | Registered Nurse | 905 E Main St, Olney, IL 62450-2623 | 2010-11-08 |
| 1497860621 | Catherine S Yockey | Registered Nurse | 905 E Main St, Olney, IL 62450-2623 | 2006-08-20 |
| 1013022250 | Denna Mitchell | Registered Nurse | 905 E Main St, Olney, IL 62450-2623 | 2006-08-20 |
| 1487769634 | Vicki Ballard | Registered Nurse | 723 E Main St, Olney, IL 62450-2619 | 2006-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144833047 | Jennifer Fay Herbert | Registered Nurse | 4011 N Francisco Ave Unit 111, Chicago, IL 60618-2655 | 2020-08-28 |
| 1225653082 | Kailin Haugh | Registered Nurse | 194 Ivy Ln, Bloomingdale, IL 60108-1726 | 2020-06-08 |
| 1841819828 | Alison Chesniak Thompson | Registered Nurse | 1857 W Diversey Pkwy Apt 301, Chicago, IL 60614-9236 | 2020-04-10 |
| 1962038935 | Wendy Lankenau | Registered Nurse | 225 E Chicago Ave Unit A, Chicago, IL 60611-2991 | 2020-03-21 |
| 1720594013 | Viktoria Mileva | Registered Nurse | 236 Tallman Ave, Romeoville, IL 60446-1746 | 2017-12-21 |
| 1205268612 | Precious Watson | Registered Nurse | 1217 E 95th St, Chicago, IL 60619-8019 | 2013-08-08 |
| 1679721633 | Cynthia L. Booth | Registered Nurse | 1801 W Taylor St # 2e, Children and Adolescent Center, Chicago, IL 60612-4319 | 2008-09-03 |
| 1942458260 | Sarah E Kelso | Registered Nurse | 4611 Golf Rd, Suite 200, Skokie, IL 60076-1209 | 2008-08-28 |
| 1295938645 | Marykay Petges | Registered Nurse | 101 Birch Dr Sw, Poplar Grove, IL 61065-8962 | 2007-06-05 |
| 1841410289 | Maureen Adele Macmillan-brown | Registered Nurse | 7028 N Ozark Ave, Chicago, IL 60631-1064 | 2007-04-26 |
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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.