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DYLAN WADE STREET
NPI 1013471424
Student in an Organized Health Care Education/Training Program in Metropolis, IL

Active since January 30, 2019
206 W 5TH ST, METROPOLIS, IL 62960(618) 524-9368 Get Directions Write a Review

NPPES record last updated: January 30, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dylan Wade Street NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DYLAN WADE STREET (NPI 1013471424) is an individual student in an organized health care education/training program in Metropolis, Illinois and active in the NPI registry since January 2019.

NPPES Registry Identity

NPI1013471424
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDYLAN WADE STREET
Location Address206 W 5TH STMetropolis, IL 62960-1810
Mailing Address206 W 5th StMetropolis, IL 62960-1810 · (618) 524-9368
Phone(618) 524-9368
Sole ProprietorYes
Enumeration DateJanuary 30, 2019
✔ NPI 1013471424 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
206 W 5TH ST, Metropolis, IL 62960
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Other Identifiers 1

Medicaid371011136002IL

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. TONI L MILLER MS LCPC
Counselor
206 W 5TH ST
METROPOLIS, IL 62960
Massac County (618) 524-9368
JENNEA HARRIS
Counselor
206 W 5TH ST
METROPOLIS, IL 62960
Massac County (618) 524-9368
OAKLEY AUTUMN WARREN
Counselor
206 W 5TH ST
METROPOLIS, IL 62960
Massac County (618) 524-9368
ASHLEY POWERS MS
Counselor
206 W 5TH ST
METROPOLIS, IL 62960
Massac County (800) 851-1251
MARYBETH CLARK BS
Counselor (Addiction (Substance Use Disorder))
206 W 5TH ST
METROPOLIS, IL 62960
Massac County (618) 524-9368
MICHAEL PROYR
Counselor (Mental Health)
206 W 5TH ST
METROPOLIS, IL 62960
Massac County (270) 556-3966
AMY KRUEGER BS
Counselor
206 W 5TH ST
METROPOLIS, IL 62960
Massac County (618) 524-9368
ZEBULUN NEW
Counselor
206 W 5TH ST
METROPOLIS, IL 62960
Massac County (618) 524-9368

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dylan Street's NPI number?

The NPI number for Dylan Street is 1013471424. It was assigned to this individual provider in the NPPES registry on January 30, 2019.

Where is Dylan Street located?

Dylan Street practices at 206 W 5th St, Metropolis, IL 62960. The listed phone number is (618) 524-9368.

What is Dylan Street's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Dylan Street was last updated on January 30, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.