PROVENA SERVICE CORPORATION


Address: 405 Sheridan St, Danville, IL 61832-4451
Phone: 2174316330

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207Q00000X Family Medicine IL Allopathic & Osteopathic Physicians

Other Provider/Organization Names

Other Name Type Code
Provena Medical Group Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1255526687 Provena Service Corporation Pediatrics 102 N Logan Ave, Danville, IL 61832-8513 2007-09-10

Office Location

Street Address 405 SHERIDAN ST
City DANVILLE
State IL
Zip Code 61832-4451

Providers in the same location

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

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 207Q00000X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine

Taxonomy Definition

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.

Providers in the same taxonomy and city

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

Competitor

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City DANVILLE
Zip Code 61832

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Dataset Information

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.

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