PROVENA SERVICE CORPORATION (NPI# 1134314602) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1134314602 |
Entity Type | Organization |
Organization Name | PROVENA SERVICE CORPORATION |
Other Organization Name | PROVENA MEDICAL GROUP |
Practice Address |
405 Sheridan St Danville IL 61832-4451 |
Mailing Address |
9223 W Saint Francis Rd Frankfort IL 60423-8330 |
Practice Telephone | 2174316330 |
Mailing Telephone | 8158063111 |
Enumeration Date | 2007-09-07 |
Last Update Date | 2008-04-20 |
Authorized Official Name | MR. DANIEL BOLAND (FINANCIAL REPORTING SPECIALIST) |
Authorized Official Telephone | 8158063111 |
Is Organization Subpart | Y |
Parent Organization Name | PROVENA SERVICE CORPORATION |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207Q00000X | Family Medicine | IL | Allopathic & Osteopathic Physicians |
Other Name | Type Code |
---|---|
Provena Medical Group | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255526687 | Provena Service Corporation | Pediatrics | 102 N Logan Ave, Danville, IL 61832-8513 | 2007-09-10 |
Street Address |
405 SHERIDAN ST |
City | DANVILLE |
State | IL |
Zip Code | 61832-4451 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437697307 | Danville Pediatric and Family Care | Point of Service | 405 Sheridan St, Danville, IL 61832-4451 | 2017-02-10 |
1154878098 | Lori Moton | Registered Nurse | 405 Sheridan St, Danville, IL 61832-4451 | 2016-09-08 |
1750633293 | Helping Hands Medical Clinic Ltd | Clinic/Center | 405 Sheridan St, Danville, IL 61832-4451 | 2012-10-08 |
1043480874 | Jeanelle Y Murphy | Family Medicine | 405 Sheridan St, Danville, IL 61832-4451 | 2008-03-07 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316593957 | Margaret Jean Heath | Technician | 310 N North St, Danville, IL 61832 | 2019-08-09 |
1215494620 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 3653 N Vermilion Dr, Danville, IL 61832 | 2019-02-22 |
1003263104 | Bayview Family Clinic | Nurse Practitioner | 3595 N Vermillion Street, Danville, IL 61832 | 2016-05-18 |
1194179499 | Kinisha Vasser | Social Worker | 1900 E. Main Steet, Danville, IL 61832 | 2016-04-22 |
1023497237 | Alpha Omega Counseling Services | Community/Behavioral Health | 120 N Vermilion, Danville, IL 61832 | 2015-05-20 |
1437557568 | Terri D. Dunn | Hearing Instrument Specialist | 733 N. Logan #4, Audibel Hearing Aids, Danville, IL 61832 | 2014-12-05 |
1518361682 | Rosemarie Renee Eck | Nurse Practitioner | 1900 E Main St, Bldg 101-171, Va Illiana Health Care System, Danville, IL 61832 | 2014-10-17 |
1497181747 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | 3649 N. Vermillion St., Danville, IL 61832 | 2013-09-18 |
1598000770 | Bayview Family Clinic Ltd | Health Maintenance Organization | 405 N. Sheridan St., Danville, IL 61832 | 2012-11-29 |
1992052666 | Katharine Lorraine Lerner | Pharmacist | 3649 N Vermilion St, Danville, IL 61832 | 2012-08-13 |
Find all providers in zip 61832 |
Taxonomy Code | 207Q00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Family Medicine |
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801431648 | Selena Michelle Richert | Family Medicine | 24359 Orange Hill Rd, Danville, OH 43014-9647 | 2019-11-15 |
1114309267 | Yi Ding | Family Medicine | 800 Memorial Dr Ste D, Danville, VA 24541-1680 | 2015-06-25 |
1285026062 | Kavita Tripathi | Family Medicine | 125 Executive Dr Ste H, Danville, VA 24541-4155 | 2015-03-03 |
1194139519 | Randy Michael Chan | Family Medicine | 109 Bridge St Ste 201, Danville, VA 24541-1222 | 2014-06-13 |
1225476120 | Natalie Alexander | Family Medicine | 201 South Main St., Suite 3200, Danville, VA 24541-2922 | 2013-06-13 |
1033472683 | Bayview Family Clinic - Danville | Family Medicine | 3595 N Vermilion St, Danville, IL 61832-1337 | 2012-06-19 |
1326322736 | Family Practice Medical Center | Family Medicine | 511 W. Fairchild Street, Danville, IL 61832 | 2011-10-04 |
1750566162 | Bashirahmed M Ameji | Family Medicine | 3820 East Main Street, Danville Correctional Center Medical Department, Danville, IL 61834-5796 | 2008-01-03 |
1376743278 | Michael R Rousse | Family Medicine | 1301 Stannard Mtn Rd, Danville, VT 05828-4417 | 2007-07-19 |
1457572604 | Kesari Md Inc | Family Medicine | 163 Prichard Rd, Danville, WV 25053 | 2007-05-02 |
Find all providers in DANVILLE |
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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.