ILLINI MEDICAL ASSOCIATES SC (NPI# 1013965698) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013965698 |
| Entity Type | Organization |
| Organization Name | ILLINI MEDICAL ASSOCIATES SC |
| Practice Address |
390 Maple Summit Rd Jerseyville IL 62052-2000 |
| Practice Telephone | 6184987518 |
| Practice Fax Number | 6184983052 |
| Mailing Telephone | 6184987518 |
| Mailing Fax Number | 6184983052 |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2015-03-24 |
| Authorized Official Name | MICHAEL S MCNEAR (CEO) |
| Authorized Official Telephone | 6184987518 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BCBS OF ILLINOIS | 4215006 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528196581 | Illini Medical Associates Sc | Otolaryngology | 4325 Alby St, Suite 204, Alton, IL 62002-5914 | 2007-03-01 |
| 1124153804 | Illini Medical Associates Sc | Family Medicine | 106 South Water St, Hardin, IL 62047-0106 | 2007-02-22 |
| 1194853069 | Illini Medical Associates Sc | Psychiatry & Neurology | 815 E 5th St, Suite 205, Alton, IL 62002-6471 | 2007-03-01 |
| 1336277573 | Illini Medical Associates Sc | Obstetrics & Gynecology | 2 Saint Anthonys Way, Alton, IL 62002-4569 | 2007-03-01 |
| 1932234622 | Illini Medical Associates Sc | Family Medicine | 523 S Main St, Carrollton, IL 62016-1251 | 2007-02-22 |
| 1841325537 | Illini Medical Associates Sc | Family Medicine | 103 Mccausland St, Carlinville, IL 62626-9133 | 2007-02-22 |
| 1467587154 | Illini Medical Associates Sc | Family Medicine | 205 S 3rd St, Girard, IL 62640-1547 | 2007-02-22 |
| Street Address |
390 MAPLE SUMMIT RD |
| City | JERSEYVILLE |
| State | IL |
| Zip Code | 62052-2000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326034919 | Srirama S Kurella | Internal Medicine | 390 Maple Summit Rd, Jerseyville, IL 62052-2000 | 2005-09-20 |
| 1700499274 | Carrie H Purdy | Nurse Practitioner | 390 Maple Summit Rd, Illini Bldg, Jerseyville, IL 62052 | 2020-08-25 |
| 1124579099 | Mary Beck | Nurse Practitioner | 390 Maple Summit Rd, Jerseyville, IL 62052 | 2016-10-17 |
| 1811392970 | Jersey Community Hospital | Clinic/Center | 390 Maple Summit Rd, Jerseyville, IL 62052-2000 | 2014-10-30 |
| 1578901930 | Illini Medical Associates, Sc | Durable Medical Equipment & Medical Supplies | 390 Maple Summit Rd, Jerseyville, IL 62052-2000 | 2013-06-07 |
| 1598036071 | Krista E Jenkins | Physician Assistant | 390 Maple Summit Rd, Jerseyville, IL 62052-2000 | 2012-01-16 |
| 1023259967 | Victoria Ann Hargrave | Registered Nurse | 390 Maple Summit Rd, Jerseyville, IL 62052-2000 | 2009-03-22 |
| 1205090644 | Colleen M Canavan | Physician Assistant | 390 Maple Summit Rd, Jerseyville, IL 62052-2000 | 2008-07-15 |
| 1215062914 | Cynthia Barrett | Clinical Nurse Specialist | 390 Maple Summit Rd, Jerseyville, IL 62052-2000 | 2007-02-22 |
| 1053345488 | Deborah Marie Seymour | Nurse Practitioner | 390 Maple Summit Rd, Jerseyville, IL 62052-2000 | 2006-07-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396265666 | Lauren Mccarthy | Podiatrist | 400 Maple Summit Rd Suite 200, Jerseyville, IL 62052 | 2017-06-27 |
| 1851757488 | German Insurance Agency | Local Education Agency (LEA) | 850 S State Street, Jerseyville, IL 62052 | 2016-01-12 |
| 1942584230 | Thomas G Honke | Pharmacist | 705 South State, Walgreens, Jerseyville, IL 62052 | 2011-10-05 |
| 1861786493 | Pain Relief Center | Clinic/Center | 903 South State Street, Jerseyville, IL 62052 | 2011-05-31 |
| 1902058845 | Ronald Lee Schroeder | Obstetrics & Gynecology | 1211 West Carpenter, Jerseyville, IL 62052 | 2008-10-22 |
| 1760696116 | Rebecca Elaine Alexander | Massage Therapist | 1301 S State St, Jerseyville, IL 62052 | 2007-05-09 |
| 1205950540 | Charles C Alexander | Chiropractor | 1301 S State, Jerseyville, IL 62052 | 2007-03-19 |
| 1902816358 | Kirk William Schultz | Chiropractor | 519 South State Street, Jerseyville, IL 62052 | 2006-08-08 |
| 1235119652 | Batool N Vali | Obstetrics & Gynecology | 1702 W. County Road, Jerseyville, IL 62052 | 2006-01-20 |
| 1649270729 | Jersey County Health Department | Public Health or Welfare | 1307 State Highway 109, Jerseyville, IL 62052 | 2005-07-29 |
| Find all providers in zip 62052 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699962498 | Robert D Childers Md Sc | Clinic/Center | 400 Maple Summit Rd, Ste 300, Jerseyville, IL 62052-2028 | 2007-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568069805 | Elite Spine & Wellness Center, Inc | Clinic/Center | 5898 Pathfinder Rd, Rockford, IL 61109-4008 | 2020-10-08 |
| 1407453236 | Dirsi, Inc | Clinic/Center | 2112 N Dayton St, Chicago, IL 60614-4302 | 2020-10-05 |
| 1588261770 | Mount Sinai Community Foundation Dba Sinai Medical Group | Clinic/Center | 2701 W 68th St Fl 3, Chicago, IL 60629-1813 | 2020-10-01 |
| 1013514298 | Mount Sinai Community Foundation Dba Sinai Medical Group | Clinic/Center | 1500 S Fairfield Ave Fl 4, Chicago, IL 60608-1782 | 2020-10-01 |
| 1841804879 | Chicago Poly Clinic LLC | Clinic/Center | 2446 W Devon Ave, Chicago, IL 60659-1913 | 2020-09-08 |
| 1386258226 | Ortho Spine Surgical LLC | Clinic/Center | 1925 E 95th St Ste 220, Chicago, IL 60617-4710 | 2020-09-08 |
| 1821607425 | Desired Medical Services Incorporated | Clinic/Center | 371 Mackinaw Ave, Calumet City, IL 60409-2524 | 2020-07-29 |
| 1639787823 | Md Infusions, Pllc | Clinic/Center | 666 Dundee Rd Ste 1800, Northbrook, IL 60062-2727 | 2020-07-14 |
| 1407474083 | Staten Family Practice Pllc | Clinic/Center | 500 W Virginia Ave, Gillespie, IL 62033-1025 | 2020-07-09 |
| 1629696679 | Serenity Internal Medicine & Wellness Center | Clinic/Center | 3330 W 177th St # 2d-1, Hazel Crest, IL 60429-2184 | 2020-07-07 |
| Find all providers with the same taxonomy | ||||
| City | JERSEYVILLE |
| Zip Code | 62052 |
Please comment or provide details below to improve the information on ILLINI MEDICAL ASSOCIATES SC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.