PREMIER PATHOLOGY SERVICES LLC


Address: 211 S 3rd St, Dept. of Pathology, Belleville, IL 62220-1915
Phone: 6182342120

PREMIER PATHOLOGY SERVICES LLC (NPI# 1306834346) 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) 1306834346
Entity Type Organization
Organization Name PREMIER PATHOLOGY SERVICES LLC
Practice Address 211 S 3rd St
Dept. of Pathology
Belleville
IL 62220-1915
Mailing Address Po Box 144333
Orlando
FL 32814-4333
Practice Telephone 6182342120
Practice Fax Number 6182224630
Mailing Telephone 4074229831
Mailing Fax Number 4076482065
Enumeration Date 2005-10-13
Last Update Date 2008-09-03
Authorized Official Name DOLPH D HAEGE (PRESIDENT)
Authorized Official Telephone 6182342120
Authorized Official Credential MD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207ZP0102X Pathology
Specialization: Anatomic Pathology & Clinical Pathology
========= IL Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
IL MEDICARE RAILROAD DD7836 01
IL ADVANTRA PIN 241644 01
IL CMR PIN 241644 01
MO 507261808 05
IL BCBS IL PIN 08232162 01
IL HEALTHLINK PIN 717892 01
IL GHP PIN 241644 01

Office Location

Street Address 211 S 3RD ST
DEPT. OF PATHOLOGY
City BELLEVILLE
State IL
Zip Code 62220-1915

Providers in the same location

NPI Name Taxonomy Address Enumeration
1851397319 Ravi Kumar Specialist 211 S 3rd St, Belleville, IL 62220-1915 2005-06-21
1720590045 Cep America - Illinois Snf, LLP Internal Medicine 211 S 3rd St, Belleville, IL 62220-1915 2017-10-26
1336670454 Therese Krause Nurse Practitioner 211 S 3rd St, Belleville, IL 62220-1915 2017-03-21
1578920591 Paul Lee Registered Nurse 211 S 3rd St, Operating Room, Belleville, IL 62220-1915 2016-01-21
1417326430 Lynlee Barnhart Nurse Practitioner 211 S 3rd St, Belleville, IL 62220-1915 2015-09-21
1518346634 Jared Sheley Pharmacist 211 S 3rd St, Belleville, IL 62220-1915 2015-05-21
1952792665 Tracie Kloeppel Nurse Anesthetist, Certified Registered 211 S 3rd St, Belleville, IL 62220-1915 2015-02-17
1184022352 Kristopher Clements Nurse Anesthetist, Certified Registered 211 S 3rd St, Belleville, IL 62220-1915 2014-12-19
1518362946 Amanda Patterson Nurse Practitioner 211 S 3rd St, Belleville, IL 62220-1915 2014-10-28
1194124032 Sharon Faye Haege Registered Nurse 211 S 3rd St, Belleville, IL 62220-1915 2014-08-16
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1144729716 St. Elizabeth's Hospital of The Hospital Sisters of The Third Order Of Clinic/Center 180 South Third Street Suite 101, Belleville, IL 62220 2018-02-08
1437675535 Prorehab PC Occupational Therapist 1915 Carlyle Ave, Ste D, Belleville, IL 62220 2017-08-21
1629527650 Arika Forrest Nurse Practitioner 140 Iowa Ave, Belleville, IL 62220 2016-10-03
1861861403 Belleville Endoscopy LLC Internal Medicine 311 West Lincoln St, Suite 101, Belleville, IL 62220 2015-09-24
1962871558 Antony Frierdich Specialist/Technologist 22 South 13th Street, Belleville, IL 62220 2015-09-24
1588032858 Dana Wright Pharmacist 211 South Thrid Street, Belleville, IL 62220 2015-09-03
1629208731 Lisa Marlow Johnson Developmental Therapist 34 Fenwood Dr, Belleville, IL 62220 2009-07-23
1841361623 Neurological Surgery of Belleville Neurological Surgery 340 West Lincoln Street, Suite 540, Belleville, IL 62220 2006-11-13
1689769119 Kathy Jo Corn Counselor 521 W. Main, Suite 201 B, Belleville, IL 62220 2006-10-03
1780609578 Southern Illinois Health Care Foundation, Inc. Counselor 180 S 3rd St Ste 103&104, Belleville, IL 62220 2006-07-13
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Taxonomy Information

Taxonomy Code 207ZP0102X
Grouping Allopathic & Osteopathic Physicians
Classification Pathology
Specialization Anatomic Pathology & Clinical Pathology

Taxonomy Definition

A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1912959206 Frank Pikul Pathology 613 E Waters Edge Dr, Belleville, IL 62221-7815 2006-05-16
1255316725 Vidya Deshpande Pathology 45 Sheffield Drive, Belleville, IL 62243 2005-12-07
1508090051 Essel Marie B De Leon Pathology 1 Clara Maass Dr, Pathology Department, Belleville, NJ 07109-3550 2009-05-13
1932355062 Allison Taylor Howard Pathology 211 S 3rd St, Belleville, IL 62220-1915 2008-08-08
1760663942 Stephen Michael Olson Pathology 211 S 3rd St, Belleville, IL 62220-1915 2007-11-16
1952400061 John Kopf Donahue Pathology 1 Clara Maass Dr, Belleville, NJ 07109-3550 2006-09-22
1487764890 Christopher Murphy Pathology 211 S 3rd St, Belleville, IL 62220-1915 2006-08-30
1841307899 Alexander David Pederson Pathology 211 S 3rd St, Dept of Pathology, Belleville, IL 62220-1915 2006-08-24
1104835842 Ram Sai Bala Pathology 211 S 3rd St, Dept. of Pathology, Belleville, IL 62220-1915 2006-08-05
1417973595 Robert Charles Benedetti Pathology 1 Clara Maass Dr, Belleville, NJ 07109-3550 2006-07-14
Find all providers in BELLEVILLE

Competitor

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City BELLEVILLE
Zip Code 62220

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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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