ILLINI MEDICAL ASSOCIATES SC (NPI# 1336277573) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336277573 |
| Entity Type | Organization |
| Organization Name | ILLINI MEDICAL ASSOCIATES SC |
| Practice Address |
2 Saint Anthonys Way Alton IL 62002-4569 |
| Mailing Address |
390 Maple Summit Rd Jerseyville IL 62052-2000 |
| Practice Telephone | 6184631111 |
| Mailing Telephone | 6184987518 |
| Mailing Fax Number | 6184983052 |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2014-11-18 |
| Authorized Official Name | MICHAEL S MCNEAR (CEO) |
| Authorized Official Telephone | 6184987518 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BCBS OF ILLINOIS | 4215006 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528196581 | Illini Medical Associates Sc | Otolaryngology | 4325 Alby St, Suite 204, Alton, IL 62002-5914 | 2007-03-01 |
| 1124153804 | Illini Medical Associates Sc | Family Medicine | 106 South Water St, Hardin, IL 62047-0106 | 2007-02-22 |
| 1194853069 | Illini Medical Associates Sc | Psychiatry & Neurology | 815 E 5th St, Suite 205, Alton, IL 62002-6471 | 2007-03-01 |
| 1932234622 | Illini Medical Associates Sc | Family Medicine | 523 S Main St, Carrollton, IL 62016-1251 | 2007-02-22 |
| 1841325537 | Illini Medical Associates Sc | Family Medicine | 103 Mccausland St, Carlinville, IL 62626-9133 | 2007-02-22 |
| 1467587154 | Illini Medical Associates Sc | Family Medicine | 205 S 3rd St, Girard, IL 62640-1547 | 2007-02-22 |
| 1013965698 | Illini Medical Associates Sc | Clinic/Center | 390 Maple Summit Rd, Jerseyville, IL 62052-2000 | 2006-05-05 |
| Street Address |
2 SAINT ANTHONYS WAY |
| City | ALTON |
| State | IL |
| Zip Code | 62002-4569 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972585677 | Dennis E. Sands | Obstetrics & Gynecology | 2 Saint Anthonys Way, Alton, IL 62002-4569 | 2005-11-17 |
| 1023584042 | Tawny Nicole Thomas | Nurse Practitioner | 2 Saint Anthonys Way, Alton, IL 62002-4569 | 2018-10-17 |
| 1992289979 | Roxanne R Strohbeck | Nurse Practitioner | 2 Saint Anthonys Way, Alton, IL 62002-4569 | 2018-09-17 |
| 1861975849 | Colin Michael Solomon | Nurse Practitioner | 2 Saint Anthonys Way, Alton, IL 62002-4569 | 2018-09-14 |
| 1639508039 | Billie Vincent | Nurse Practitioner | 2 Saint Anthonys Way, Suite 205, Alton, IL 62002-4569 | 2013-11-06 |
| 1790065464 | Saikiran Raghavapuram | Internal Medicine | 2 Saint Anthonys Way, Alton, IL 62002-4569 | 2011-08-25 |
| 1407144231 | Kate A Smith | Physician Assistant | 2 Saint Anthonys Way, Suite 305, Alton, IL 62002-4569 | 2011-07-13 |
| 1700112521 | Lisa M Fritcher | Physician Assistant | 2 Saint Anthonys Way, Alton, IL 62002-4569 | 2009-10-29 |
| 1851524011 | Carole H Mckinstry | Nurse Practitioner | 2 Saint Anthonys Way, Suite 305, Alton, IL 62002-4569 | 2009-09-03 |
| 1902062862 | Priya Kumaraguru | Family Medicine | 2 Saint Anthonys Way, Suite 205, Alton, IL 62002-4569 | 2008-07-31 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285272807 | Jersey Community Hospital | Obstetrics & Gynecology | #2 Memorial Drive, Suite 203, Alton, IL 62002 | 2019-12-13 |
| 1912540659 | Kelsi N Harre | Community Health Worker | 2603 N. Rogers Ave., Alton, IL 62002 | 2019-10-25 |
| 1841848322 | Destiny L Miller | Technician | 3429 Meridocia St, Alton, IL 62002 | 2019-08-28 |
| 1942854633 | Jessica Leigh Jump | Speech-Language Pathologist | 453 Bluff Street, Alton, IL 62002 | 2019-07-30 |
| 1194380741 | Vasiliki Kytridou | Dentist | 2800 College Avenue Southern Il University School of De, Building 285, Alton, IL 62002 | 2019-05-08 |
| 1982125910 | Amy Nicole Spalding | Social Worker | 1123 Harrison St, Alton, IL 62002 | 2017-06-29 |
| 1962856310 | Patricia Gregory | Social Worker | 5090 Humbert Rd, Alton, IL 62002 | 2016-04-21 |
| 1447612510 | Alanna Lynn Mcnelly | Chiropractor | 219 Piasa St, Suite 200, Alton, IL 62002 | 2016-03-28 |
| 1174983050 | Roberta's Lovely Ladies Boutique | Mastectomy Fitter | 603 W. Delmar, Alton, IL 62002 | 2016-03-04 |
| 1184081556 | Darcy Graham | Nurse Practitioner | 4 Memorial Dr # 210, Alton, IL 62002 | 2016-01-15 |
| Find all providers in zip 62002 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285272807 | Jersey Community Hospital | Obstetrics & Gynecology | #2 Memorial Drive, Suite 203, Alton, IL 62002 | 2019-12-13 |
| 1922403096 | Jersey Community Hospital | Obstetrics & Gynecology | 2 Memorial Dr Ste 203, Alton, IL 62002-6723 | 2014-10-30 |
| 1639518913 | Bindu N Patel | Obstetrics & Gynecology | 4 Memorial Dr Ste 125, Alton, IL 62002-6704 | 2013-06-19 |
| 1972585677 | Dennis E. Sands | Obstetrics & Gynecology | 2 Saint Anthonys Way, Alton, IL 62002-4569 | 2005-11-17 |
| 1093060584 | Jamie Hardman | Obstetrics & Gynecology | 4 Memorial Dr Ste 210, Alton, IL 62002 | 2012-07-20 |
| 1730318890 | Rachel Durham | Obstetrics & Gynecology | 1 Professional Dr, Alton, IL 62002-5068 | 2009-07-10 |
| 1942350202 | James Watson Stubbs Jr. | Obstetrics & Gynecology | 2 Memorial Dr, 122, Alton, IL 62002-6723 | 2007-01-11 |
| 1972699932 | Charles D. Herzon | Obstetrics & Gynecology | 2 Memorial Dr, Suite 122, Alton, IL 62002-6723 | 2006-10-05 |
| 1174619225 | Geoffrey L. Turner | Obstetrics & Gynecology | 4 Memorial Dr Ste 210, Alton, IL 62002 | 2006-10-05 |
| 1770594723 | Sara M Cannon | Obstetrics & Gynecology | 2 Saint Anthonys Way, Ste 105, Alton, IL 62002 | 2006-08-11 |
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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.