ELITE MEDICAL GROUP (NPI# 1356560999) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356560999 |
| Entity Type | Organization |
| Organization Name | ELITE MEDICAL GROUP |
| Practice Address |
3002 Gill St Bloomington IL 61704-3438 |
| Mailing Address |
Po Box 710 Bloomington IL 61702-0710 |
| Practice Telephone | 3096634443 |
| Mailing Telephone | 3096634443 |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | CRAIG MATHIESON (PARTNER) |
| Authorized Official Telephone | 3096634443 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | IL | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497182596 | Elite Medical Group | General Practice | 20265 Valley Blvd Ste E, Walnut, CA 91789-2655 | 2013-10-03 |
| 1700147063 | Elite Medical Group | Nurse Practitioner | 3965 Glen Park Dr, Lithonia, GA 30038-3692 | 2012-06-04 |
| 1023248234 | Elite Medical Group | Family Medicine | 7920 Belt Line Rd, Suite # 120, Dallas, TX 75254-8145 | 2009-07-22 |
| Street Address |
3002 GILL ST |
| City | BLOOMINGTON |
| State | IL |
| Zip Code | 61704-3438 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538316815 | Peggy Jean Ziel | Specialist/Technologist, Other | 3002 Gill St, Suite #3, Bloomington, IL 61704-3438 | 2008-08-19 |
| 1609022292 | Therese Marie Lesmeister | Specialist/Technologist, Other | 3002 Gill St, Suite#3, Bloomington, IL 61704-3438 | 2008-08-14 |
| 1194971846 | Melissa Louise Parochetti | Specialist/Technologist, Other | 3002 Gill St, Suite#3, Bloomington, IL 61704-3438 | 2008-08-13 |
| 1578722724 | Amber Deshea Lee | Specialist/Technologist, Other | 3002 Gill St, Suite #3, Bloomington, IL 61704-3438 | 2008-06-03 |
| 1487812178 | Paula Delores Malone | Specialist/Technologist, Other | 3002 Gill St, Suite #3, Bloomington, IL 61704-3438 | 2008-05-29 |
| 1689841835 | Deanne Marie Burnett | Specialist/Technologist, Other | 3002 Gill St, Suite 3, Bloomington, IL 61704 | 2008-05-15 |
| 1205017266 | Khin Aye Htwe | Specialist/Technologist, Other | 3002 Gill St, Bloomington, IL 61704-3438 | 2007-11-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518430859 | Visionpoint Eye Center LLC | Optometrist | 1107 Airport Road, Bloomington, IL 61704 | 2019-01-09 |
| 1922588235 | Geethu Sabu Makil | Speech-Language Pathologist | 1039 Blueheron Way, Apt#3, Bloomington, IL 61704 | 2018-08-16 |
| 1629596812 | Mental Wellness Center Inc | Counselor | 202 N Prospect Rd Ste 207, Bloomington, IL 61704 | 2017-09-07 |
| 1649798513 | Sarah Goodner | Psychologist | 1704 Royal Pointe Drive, Bloomington, IL 61704 | 2017-08-31 |
| 1346760253 | Elizabeth Devlin | Nurse Practitioner | 25 Long Cove Ct, Bloomington, IL 61704 | 2017-06-21 |
| 1396107918 | Darla Schwertfeger | Specialist/Technologist, Other | 2104 Hedgewood Dr, Bloomington, IL 61704 | 2016-03-23 |
| 1740662949 | Oncology Hematology Associates of Central Illinois | Pharmacy | 3105 Magory Drive, Bloomington, IL 61704 | 2015-06-24 |
| 1821478967 | Kelly R Andrews | Massage Therapist | 4101 Wicker Rd, Bloomington, IL 61704 | 2015-06-03 |
| 1235522582 | All Ways Caring Services, Inc. | In Home Supportive Care | 209 S Prospect Rd, Suite 3e, Bloomington, IL 61704 | 2015-03-11 |
| 1396093977 | Bhawna Gupta | Physical Therapist | 2200 East Washington Street, Bloomington, IL 61704 | 2012-08-29 |
| Find all providers in zip 61704 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245797646 | D B Medical Supplies Inc | Durable Medical Equipment & Medical Supplies | 2601 General Electric Rd Ste 4, Bloomington, IL 61704-3437 | 2019-02-22 |
| 1538648571 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 702 W Chestnut St Ste 103, Bloomington, IL 61701-2814 | 2018-08-10 |
| 1881193274 | Orthopedic Rehabilitation Supply LLC | Durable Medical Equipment & Medical Supplies | 13 Norbloom Ave, Bloomington, IL 61701-1949 | 2018-02-12 |
| 1821504697 | Wig Wam Boutique LLC | Durable Medical Equipment & Medical Supplies | 313 W 17th St, Bloomington, IN 47404-3453 | 2017-12-15 |
| 1033622824 | Kroger Limited Partnership I | Durable Medical Equipment & Medical Supplies | 1825 N Kinser Pike, Bloomington, IN 47404-1914 | 2017-11-15 |
| 1629509732 | Touchway LLC | Durable Medical Equipment & Medical Supplies | 60 E Broadway, Bloomington, MN 55425-5510 | 2017-03-22 |
| 1437697935 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 445 S Landmark Ave Ste P, Bloomington, IN 47403-5004 | 2017-02-03 |
| 1861875403 | Hook Superx LLC | Durable Medical Equipment & Medical Supplies | 121 E Kirkwood Ave, Bloomington, IN 47408-3331 | 2015-07-01 |
| 1639479140 | Home Health Depot | Durable Medical Equipment & Medical Supplies | 13 Westport Ct, Unit B, Bloomington, IL 61704-3626 | 2010-10-31 |
| 1316178064 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 1130 S Veterans Pkwy, Bloomington, IL 61704 | 2009-07-29 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 61704 |
Please comment or provide details below to improve the information on ELITE MEDICAL GROUP.
| 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.