# MIDWEST NEUROMONITORING, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1831360239
- **Authorized official:** TERRY MCKENNA MS, CNIM (PRESIDENT)
- **Authorized official phone:** (309) 820-7982

## Contact information

- **Practice address:** 1015 S MERCER AVE, BLOOMINGTON, IL 61701-7107
- **Practice address phone:** (309) 820-7982
- **Practice address fax:** (309) 820-7982
- **Mailing address:** 1015 S MERCER AVE, BLOOMINGTON, IL 61701-7107
- **Mailing address phone:** (309) 820-7982
- **Mailing address fax:** (309) 820-7982

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 293D00000X | Physiological Laboratory | — | — | Yes |

## Other

- **Enumeration date:** 03/13/2008
- **Last updated:** 03/13/2008