PROVENA HOSPITALS (NPI# 1295054369) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295054369 |
| Entity Type | Organization |
| Organization Name | PROVENA HOSPITALS |
| Other Organization Name | PUSMC PHYSICIAN BILLING |
| Practice Address |
812 N Logan Ave Danville IL 61832-3752 |
| Practice Telephone | 2174485000 |
| Practice Fax Number | 2174772966 |
| Mailing Telephone | 2174485000 |
| Mailing Fax Number | 2174772966 |
| Enumeration Date | 2010-05-27 |
| Last Update Date | 2010-05-27 |
| Authorized Official Name | DEBORAH SCHIMEROWSKI (CFO) |
| Authorized Official Telephone | 2174772737 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
036086987 | IL | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| PUSMC PHYSICIAN BILLING | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215025762 | Provena Hospitals | Pharmacy | 1315 N Highland Ave Ste 101, Aurora, IL 60506-1459 | 2006-10-10 |
| 1750610903 | Provena Hospitals | Obstetrics & Gynecology | 1325 N Highland Ave, Aurora, IL 60506-1449 | 2009-12-17 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | PROVENA HOSPITALS INC. | 9223 W St Francis Rd, Frankfort, IL 60423 |
| Street Address |
812 N LOGAN AVE |
| City | DANVILLE |
| State | IL |
| Zip Code | 61832-3752 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770585267 | Damon C. Green | Anesthesiology | 812 N Logan Ave, Anesthesia, Danville, IL 61832-3752 | 2005-08-15 |
| 1649884354 | Arianna Alexis Watson | Dietitian, Registered | 812 N Logan Ave, Danville, IL 61832-3752 | 2020-09-01 |
| 1821601618 | Rachel Cooper | Dietitian, Registered | 812 N Logan Ave, Danville, IL 61832-3752 | 2020-08-31 |
| 1730738543 | Valorie Lea Mcmillan | Nurse Practitioner | 812 N Logan Ave, Danville, IL 61832-3752 | 2019-09-05 |
| 1669934865 | Lacey J Youhas | Nurse Practitioner | 812 N Logan Ave, Danville, IL 61832-3752 | 2019-04-05 |
| 1003370990 | Randi M Morgan | Nurse Practitioner | 812 N Logan Ave, Danville, IL 61832-3752 | 2019-01-25 |
| 1467921627 | Carter Kenny Mcgowen | Physician Assistant | 812 N Logan Ave, Danville, IL 61832-3752 | 2018-11-17 |
| 1720557341 | Courtney M. Montel | Nurse Practitioner | 812 N Logan Ave, Danville, IL 61832-3752 | 2018-11-14 |
| 1841770534 | Le Ann Galbraith | Nurse Practitioner | 812 N Logan Ave, Danville, IL 61832-3752 | 2018-08-21 |
| 1750875340 | Nicole Marie Gowan | Nurse Practitioner | 812 N Logan Ave, Danville, IL 61832-3752 | 2018-06-18 |
| Find all providers in the same location | ||||
| 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 | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417035627 | Cancer Center of The Piedmont | Internal Medicine | 173 Executive Drive, Danville, VA 24541 | 2006-11-02 |
| 1326053299 | Jomel S Labayog | Internal Medicine | 806 N Logan, Danville, IL 61832 | 2006-07-29 |
| 1205812153 | James G Gallagher | Internal Medicine | 1407 Red Ln, Danville, PA 17821-8467 | 2005-12-21 |
| 1013919398 | Timothy Wayne Brotherton | Internal Medicine | 125 Executive Dr, Ste J, Danville, VA 24541-4155 | 2005-06-01 |
| 1861995870 | Muhammad Altaf Memon | Internal Medicine | 100 N Academy Ave, Danville, PA 17822-9800 | 2018-03-15 |
| 1407264153 | Prianka Bhattacharya | Internal Medicine | 100 N Academy Ave, Danville, PA 17822-1461 | 2014-07-25 |
| 1235578634 | Rashmika Rushikesh Potdar | Internal Medicine | 100 N Academy Ave, Danville, PA 17822-3018 | 2013-06-19 |
| 1972865863 | Li Zhang | Internal Medicine | 100 N Academy Ave, Danville, PA 17822 | 2012-06-15 |
| 1922365568 | Parth Rajeshkumar Rao | Internal Medicine | 100 N Academy Ave, Danville, PA 17822-5672 | 2012-04-20 |
| 1063791119 | Ankit Madan | Internal Medicine | 142 S Main St, Danville, VA 24541-2922 | 2011-08-08 |
| 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.