BROWN BOULEVARD SURGICAL SUITES (NPI# 1235598954) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235598954 |
| Entity Type | Organization |
| Organization Name | BROWN BOULEVARD SURGICAL SUITES |
| Practice Address |
461 Brown Blvd Suite A Bourbonnais IL 60914-2322 |
| Practice Telephone | 8159327242 |
| Practice Fax Number | 8159327307 |
| Enumeration Date | 2016-02-23 |
| Last Update Date | 2016-02-23 |
| Authorized Official Name | DR. DONALD ROLAND (OWNER/PHYSICIAN) |
| Authorized Official Telephone | 8159327242 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP3300X |
Clinic/Center Specialization: Pain |
Ambulatory Health Care Facilities |
| Street Address |
461 BROWN BLVD SUITE A |
| City | BOURBONNAIS |
| State | IL |
| Zip Code | 60914-2322 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821074600 | Donald E Roland | Anesthesiology | 461 Brown Blvd, Bourbonnais, IL 60914-2322 | 2005-12-22 |
| 1275846958 | Universal Pain Management Institute Ltd | Neurological Surgery | 461 Brown Blvd, Suite A, Bourbonnais, IL 60914-2463 | 2010-07-22 |
| 1871524629 | Giovanni Salerno Md PC | Surgery | 461 Brown Blvd, Bourbonnais, IL 60914-2322 | 2006-07-06 |
| 1093747636 | Doreena M Mcbride Md PC | Pediatrics | 461 Brown Blvd, Bourbonnais, IL 60914-2322 | 2006-07-06 |
| 1801830799 | Doreena M Mcbride | Pediatrics | 461 Brown Blvd, Bourbonnais, IL 60914-2322 | 2006-06-15 |
| 1942242698 | Giovanni M Salerno | Surgery | 461 Brown Blvd, Bourbonnais, IL 60914-2322 | 2006-06-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326648023 | Jacob Daniel Ledesma | Physical Therapist | 588 William R Latham Senior Dr Ste 5, Bourbonnais, IL 60914 | 2020-10-30 |
| 1467069823 | Alicia Nicole Kendra | Nurse Practitioner | Upliftedcare, 482 Main St. Nw, Bourbonnais, IL 60914 | 2020-09-29 |
| 1043860877 | Victor Manuel Vazquez Cervantes | Pharmacist | 2080 No, Il-50, Bourbonnais, IL 60914 | 2019-09-13 |
| 1740843267 | Panoptic Physical Therapy LLC | Physical Medicine & Rehabilitation | 1511 N. Convent St Suite 1000, Bourbonnais, IL 60914 | 2019-04-19 |
| 1770074577 | Colin P Koerner | Physical Therapist | 215 N Convent St Ste 6, Bourbonnais, IL 60914 | 2018-05-29 |
| 1306337340 | Megan Hoskins | Behavior Technician | 3187 N 2420 W Rd., Bourbonnais, IL 60914 | 2018-05-25 |
| 1932600459 | Thomas H George Dds PC | Clinic/Center | 14 Briarcliff Professional Center, Bourbonnais, IL 60914 | 2018-02-21 |
| 1780193904 | Kathleen M Saindon II | Speech-Language Pathologist | 1021 Deer Trail, Bourbonnais, IL 60914 | 2017-09-20 |
| 1457870206 | Janet Mary Notton | Speech-Language Pathologist | 920 W Margaret Lane, Bourbonnais, IL 60914 | 2017-09-13 |
| 1134646375 | Sagar Batish | Student in an Organized Health Care Education/Training Program | 1096 Country Lane, Bourbonnais, IL 60914 | 2017-08-28 |
| Find all providers in zip 60914 | ||||
| Taxonomy Code | 261QP3300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Pain |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790244150 | Paradise Point Spa | Clinic/Center | 3207 Lake Ave Ste 13, Wilmette, IL 60091-1082 | 2019-03-15 |
| 1932610110 | Julia Rackley Perry Memorial Hospital | Clinic/Center | 530 Park Ave E Fl 3, Princeton, IL 61356-3901 | 2017-10-16 |
| 1538606470 | Naprapathy University | Clinic/Center | 320 E 21st St, Unit 405, Chicago, IL 60616-3190 | 2017-01-30 |
| 1306216403 | Chicago Pain and Wellness Institute S.c. | Clinic/Center | 665 W North Ave, Suite 101, Lombard, IL 60148-1134 | 2015-10-01 |
| 1134597636 | Great River Pain Clinic LLC | Clinic/Center | 555 N Kellogg St, Galesburg, IL 61401-3726 | 2015-09-14 |
| 1649651951 | Wellness Institute of Illinois, Ltd. | Clinic/Center | 741 S Mchenry Ave Ste G, Crystal Lake, IL 60014-7445 | 2015-06-11 |
| 1558618512 | Precision Diagnostics | Clinic/Center | 18623 81st Ave, Tinley Park, IL 60487-6279 | 2012-08-09 |
| 1962637157 | Interventional Pain Medicine of Jacksonville, LLC | Clinic/Center | 1440 West Walnut Street, Jacksonville, IL 62650-0000 | 2009-05-18 |
| 1952565384 | Aaa Headache and Pain Clinic Ltd | Clinic/Center | 1449 N Milwaukee Ave, Libertyville, IL 60048-1310 | 2008-07-15 |
| 1639332505 | Interventional Pain Medicine LLC | Clinic/Center | 1 Bronze Pointe Blvd, Suite 1-a, Swansea, IL 62226-1045 | 2008-07-09 |
| Find all providers with the same taxonomy | ||||
| City | BOURBONNAIS |
| Zip Code | 60914 |
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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.