OTTAWA MEDICAL CENTER, PC (NPI# 1184649410) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184649410 |
| Entity Type | Organization |
| Organization Name | OTTAWA MEDICAL CENTER, PC |
| Practice Address |
1614 E Norris Dr Ottawa IL 61350-3681 |
| Practice Telephone | 8154331010 |
| Practice Fax Number | 8154330067 |
| Mailing Telephone | 8154331010 |
| Mailing Fax Number | 8154330067 |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2008-06-20 |
| Authorized Official Name | MRS. JILL L LOWE (ACCOUNTING CLERK) |
| Authorized Official Telephone | 8154313265 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
042-000502 | IL | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992879126 | Ottawa Medical Center, PC | Clinic/Center | 1614 E Norris Dr, Ottawa, IL 61350-3681 | 2006-11-20 |
| Street Address |
1614 E NORRIS DR |
| City | OTTAWA |
| State | IL |
| Zip Code | 61350-3681 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356336952 | Gueorgui S Gueorguiev | Family Medicine | 1614 E Norris Dr, Ottawa, IL 61350-3681 | 2005-09-20 |
| 1740769298 | Loni F Nolte | Social Worker | 1614 E Norris Dr, Ottawa, IL 61350-3681 | 2018-08-07 |
| 1609227081 | Heather M Johnston | Nurse Practitioner | 1614 E Norris Dr, Ottawa, IL 61350-3681 | 2016-06-27 |
| 1013382209 | Sherri L Albert | Nurse Practitioner | 1614 E Norris Dr, Ottawa, IL 61350-3681 | 2015-12-14 |
| 1730560822 | Austin David Martin | Family Medicine | 1614 E Norris Dr, Ottawa, IL 61350-3681 | 2015-06-15 |
| 1659771863 | Justine Mucci | Nurse Practitioner | 1614 E Norris Dr, Ottawa, IL 61350-3681 | 2014-08-26 |
| 1760891766 | Danielle Pagano | Registered Nurse | 1614 E Norris Dr, Ottawa, IL 61350 | 2014-08-05 |
| 1659620342 | Kayla A Simons | Nurse Practitioner | 1614 E Norris Dr, Ottawa, IL 61350-3681 | 2012-09-10 |
| 1063749596 | Ottawa Regional Medical Center Inc. | Family Medicine | 1614 E Norris Dr, Ottawa, IL 61350-3681 | 2009-11-04 |
| 1548429509 | Ami M Dose | Nurse Practitioner | 1614 E Norris Dr, Ottawa, IL 61350-3681 | 2008-06-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306336359 | Yulandist Jeannie Brown | Licensed Practical Nurse | 617 Columbus St, Ottawa, IL 61350 | 2018-05-15 |
| 1881071272 | Ashlee Herbold | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1718 N 2525th Rd, Ottawa, IL 61350 | 2015-05-05 |
| 1053702365 | Wanda Rohl | Social Worker | 3735 E 1453 Rd, Ottawa, IL 61350 | 2015-02-09 |
| 1538550868 | Erin Rose Boe | Physical Therapist | 2872 Columbus St, Unit 300, Ottawa, IL 61350 | 2015-02-09 |
| 1346572757 | Rebecca Samolitis | Counselor | 116 W Lafayette St, Suite 8, Ottawa, IL 61350 | 2010-02-10 |
| 1235383266 | Timothy I Miller O.d. P.C. | Optometrist | 107 E. Mckinley Rd., Ottawa, IL 61350 | 2008-11-04 |
| 1427204676 | Leo John Meagher | Counselor | 218 West Madison St, Ottawa, IL 61350 | 2008-08-07 |
| 1598938755 | Radiation Oncology of Northern Illinois LLC | Radiology | 1200 Starfire Dr, Ottawa, IL 61350 | 2008-04-09 |
| 1154538510 | Serenityonwheels, Inc. | Counselor | Serenity On Wheels, Inc. 630 Columbus Street, Ste # 214, Ottawa, IL 61350 | 2007-05-16 |
| 1205040904 | Dixie Devry | Occupational Therapist | 2532 Reynolds Manor, Ottawa, IL 61350 | 2007-05-10 |
| Find all providers in zip 61350 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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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.