CARLE BROMENN MEDICAL CENTER (NPI# 1104442615) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104442615 |
| Entity Type | Organization |
| Organization Name | CARLE BROMENN MEDICAL CENTER |
| Other Organization Name | BROMENN FAMILY HEALTH CLINIC |
| Practice Address |
1300 Franklin Ave Ste 100 Normal IL 61761-3676 |
| Mailing Address |
1304 Franklin Ave Normal IL 61761-3558 |
| Practice Telephone | 3094541400 |
| Mailing Telephone | 3094541400 |
| Enumeration Date | 2020-06-20 |
| Last Update Date | 2020-06-20 |
| Authorized Official Name | ARON KLEIN (CFO) |
| Authorized Official Telephone | 3092682410 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Bromenn Family Health Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962424036 | Carle Bromenn Medical Center | General Acute Care Hospital | 1304 Franklin Ave, Normal, IL 61761-3558 | 2006-07-24 |
| 1306867866 | Carle Bromenn Medical Center | Rehabilitation Unit | 1304 Franklin Ave, Normal, IL 61761-3558 | 2006-07-21 |
| Street Address |
1300 FRANKLIN AVE STE 100 |
| City | NORMAL |
| State | IL |
| Zip Code | 61761-3676 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235263385 | Stacey Thao Phan | General Practice | 1300 Franklin Ave Ste 100, Normal, IL 61761-3676 | 2007-03-14 |
| 1023392396 | Rachel Christine Dalal | Family Medicine | 1300 Franklin Ave Ste 100, Normal, IL 61761-3676 | 2011-10-05 |
| 1124302708 | David Cummings | Family Medicine | 1300 Franklin Ave Ste 100, Normal, IL 61761-3676 | 2011-09-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629681796 | Brittany Nicole Mekley | Nurse Practitioner | 201 N. University, Normal, IL 61761 | 2020-08-28 |
| 1679108971 | Krystal Halliday | Occupational Therapist | 1815 N Towanda Barnes Rd, Normal, IL 61761 | 2020-03-06 |
| 1265915474 | Laine E Burek | Nurse Practitioner | 1765 Bradford Ln., Normal, IL 61761 | 2018-09-13 |
| 1801389986 | Ashley Michelle James | Specialist/Technologist | 347 S. University St, Normal, IL 61761 | 2018-06-12 |
| 1447750708 | Shelley R. Ruch | Specialist/Technologist, Other | 1604 Visa Drive, Ste 1, Normal, IL 61761 | 2018-02-13 |
| 1497275069 | Mclean County Nursing Home | Non-emergency Medical Transport (VAN) | 901 N. Main St, Normal, IL 61761 | 2017-06-23 |
| 1235673666 | Megan Threm | Registered Nurse | 900 Franklin Ave Community Health Care Clinic, Normal, IL 61761 | 2016-12-04 |
| 1437513553 | Tiesha Smith | Specialist | 1800 Rockingham Dr, Apt 1d, Normal, IL 61761 | 2016-04-06 |
| 1285031658 | New Day Recovery | Community/Behavioral Health | 402 Summit, Normal, IL 61761 | 2014-12-01 |
| 1174927701 | Alyssa Marie Bruck | Occupational Therapist | 700 N Walnut St, Normal, IL 61761 | 2014-10-10 |
| Find all providers in zip 61761 | ||||
| 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 |
|---|---|---|---|---|
| 1972946739 | The Baby Fold | Clinic/Center | 108 E Willow St, Normal, IL 61761-1640 | 2013-04-11 |
| 1275974545 | Johnson Chiropractic, Sc | Clinic/Center | 310 Susan Dr, Suite 2, Normal, IL 61761-6246 | 2013-07-15 |
| 1477884211 | Advocate Health and Hospitals Corp. | Clinic/Center | 1300 Franklin Ave, Suite 100, Normal, IL 61761-3592 | 2010-01-19 |
| 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 | ||||
Please comment or provide details below to improve the information on CARLE BROMENN MEDICAL CENTER.
| 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.