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BLOOMINGTON NORMAL HEALTHCARE, LLC
NPI 1083613327
Clinic/Center - Ambulatory Surgical in Normal, IL

Active since July 19, 2005CLIA 14D0991589 · Waiver
2100 FORT JESSE RD, NORMAL, IL 61761(309) 834-4000(309) 834-4007 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Bloomington Normal Healthcare, Llc NPPES

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

BLOOMINGTON NORMAL HEALTHCARE, LLC (NPI 1083613327) is a healthcare organization registered as an ambulatory surgical in Normal, Illinois and active in the NPI registry since July 2005. The organization holds a CLIA Waiver certificate valid through September 24, 2027 and lists Thomas B Kulb, Physician/owner, as its authorized official.

NPPES Registry Identity

NPI1083613327
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameBLOOMINGTON NORMAL HEALTHCARE, LLC
Location Address2100 FORT JESSE RDNormal, IL 61761-9370
Mailing Address2100 Fort Jesse RdNormal, IL 61761-9370 · (309) 834-4000 · Fax (309) 834-4007
Phone(309) 834-4000
Fax(309) 834-4007
Organization SubpartNo
Authorized OfficialThomas B KulbPhysician/owner · (309) 834-4000
Enumeration DateJuly 19, 2005
Last NPPES UpdateAugust 22, 2020
✔ NPI 1083613327 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
License✔ Licensed in IL · 7002512
2100 FORT JESSE RD, Normal, IL 61761
Open in Google Maps ↗

Other Identifiers 1

Other50181IL · Bcbs

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D0991589

Bloomington Normal Healthcare Surgery Center · Normal, IL
Active · expires Sep 24, 2027
CLIA Number14D0991589
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateSeptember 25, 2025
Certificate Expiration DateSeptember 24, 2027
Laboratory DirectorMichelle L. Rider
Laboratory Phone(217) 855-9608
Laboratory LocationBloomington Normal Healthcare Surgery Center2100 Fort Jesse Road, Normal, IL 61761
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

FRANSEN AND KULB UROLOGY, LTD
Clinic/Center (Lithotripsy)
2100 FORT JESSE RD
NORMAL, IL 61761
McLean County (309) 834-4000

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 Bloomington Normal Healthcare, LLC's NPI number?

The NPI number for Bloomington Normal Healthcare, LLC is 1083613327. It was assigned to this organization in the NPPES registry on July 19, 2005.

Where is Bloomington Normal Healthcare, LLC located?

Bloomington Normal Healthcare, LLC is located at 2100 Fort Jesse Rd, Normal, IL 61761. The listed phone number is (309) 834-4000.

What is Bloomington Normal Healthcare, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Does Bloomington Normal Healthcare, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D0991589) is associated with this NPI, valid through September 24, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Bloomington Normal Healthcare, LLC was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.