IndividualActive
Andrew Zavala, IDMT
NPI 1164656088 · Independent Duty Medical Technicians · Scott Afb, IL
Provider details
- NPI number
- 1164656088
- Entity type
- Individual
- Primary specialty
- Independent Duty Medical TechniciansOther Service Providers
- Credential
- IDMT
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Other Service Providers
Profile Score
Detailed profile(79/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
83% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
310 W Losey St
375th Mdg/Sgopg
Scott Afb, IL 62225-5250
Phone: (618) 256-7129
Street-level locationGet directions
Mailing address
4883 Lively Ct Unit a
Scott Afb, IL 62225-6782
Registry dates
- Enumerated
- 2009-05-06
- Last updated
- 2009-05-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.