MISKELL MEDICAL LLC
NPI 1750756979
Clinic/Center - Health Service in Ottawa, IL

NPI Status: Active since December 14, 2015

Contact Information

218 W MADISON ST
OTTAWA, IL
ZIP 61350
Phone: (815) 431-1122
Fax: (815) 431-0318

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  • Organization
  • Clinic/Center
  • Health Service
  • CLIA Number: 14D2107071
  • CLIA Cert. Type: Practitioner Other
  • CLIA Exp. Date: 01-05-2026

About MISKELL MEDICAL LLC

This page provides the complete NPI Profile along with additional information for Miskell Medical Llc, a provider established in Ottawa, Illinois operating as a Clinic/center, focusing in health service . The healthcare provider is registered in the NPI registry with number 1750756979 assigned on December 2015. The practitioner's primary taxonomy code is 261QH0100X with license number 209009286 (IL). The provider is registered as an organization and their NPI record was last updated 4 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Jessica Miskell Fnp (Owner/provider)

NPI
1750756979
Provider Name
MISKELL MEDICAL LLC
Entity Type
Organization
Location Address
218 W MADISON ST OTTAWA, IL 61350
Location Phone
(815) 431-1122
Location Fax
(815) 431-0318
Mailing Address
218 W MADISON ST OTTAWA, IL 61350
Mailing Phone
(815) 431-1122
Mailing Fax
(815) 431-0318
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
12-14-2015
Last Update Date
02-04-2021
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Health Service

Taxonomy Code
261QH0100X
Type
Ambulatory Health Care Facilities
License No.
209009286
License State
IL

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1363LF0000XPhysician Assistants & Advanced Practice Nursing Providers

Nurse Practitioner
Family

 

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

JESSICA MISKELL FNP

Authorized Official Title
OWNER/PROVIDER
Authorized Official Phone
(815) 431-1122

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
1710256631OTHER (01)ILINDIVIDUAL NPI

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
14D2107071
Facility Type
Practitioner Other
Certificate Effective Date
January 06, 2024
Certificate Expiration Date
January 05, 2026
Laboratory Director
JESSICA R. MISKELL
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Miskell Medical Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1750756979
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2710014512914
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 1 + 0 + 0 + 1 + 4 + 5 + 1 + 2 + 9 + 1 + 4 + 24 = 61
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 61 = 99

The NPI number 1750756979 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following provider is registered at the same or nearby location.

JESSICA R MISKELL INDEPENDENT APN

Nurse Practitioner

(Family)

218 W MADISON ST
OTTAWA, IL
ZIP 61350

(815) 431-1122

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1750756979, enumerated as an "organization" on December 14, 2015.

The provider is located at 218 W MADISON ST OTTAWA, IL 61350 and the phone number is (815) 431-1122.

Clinic/Center with taxonomy code 261QH0100X and a focus in Health Service.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.