MR. TOMMY BOHANNAN (NPI# 1407213796) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407213796 |
| Entity Type | Individual |
| Full Name | MR. TOMMY BOHANNAN |
| Practice Address |
11417 N Boulder Creek Ct Dunlap IL 61525-1500 |
| Practice Telephone | 3096788081 |
| Mailing Telephone | 3096788081 |
| Enumeration Date | 2016-01-19 |
| Last Update Date | 2016-03-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| Street Address |
11417 N BOULDER CREEK CT |
| City | DUNLAP |
| State | IL |
| Zip Code | 61525-1500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225499080 | Bohannan Medical Dist., LLC | Durable Medical Equipment & Medical Supplies | 11417 N Boulder Creek Ct, Dunlap, IL 61525-1500 | 2016-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821512674 | Kids Thrive Therapy, LLC | Speech-Language Pathologist | 11221 N Blackstone Court, Dunlap, IL 61525 | 2017-08-02 |
| 1679857536 | Manish Patel | Pharmacist | 1700 W. Hickory Grove Rd, Apt 3-209, Dunlap, IL 61525 | 2011-10-10 |
| 1134302839 | Thomas Rickey | Pharmacist | 10424 N Osage Ct, Dunlap, IL 61525 | 2007-12-17 |
| 1427116854 | Maple Shade Dental Group | Dentist | 11825 N Knoxville Ave, Dunlap, IL 61525 | 2006-12-05 |
| 1437770872 | Laurie Michelle Kaplan | Dietitian, Registered | 12603 N. Feucht Rd, Dunlap, IL 61525-6152 | 2020-04-27 |
| 1255859575 | Kay Lynn Trilikis | Speech-Language Pathologist | 11230 N Greenview Ln, Dunlap, IL 61525-7542 | 2017-09-07 |
| 1891944864 | Naby Nature's Hand Inc | Massage Therapist | 307 S 4th St, Dunlap, IL 61525-8025 | 2008-09-15 |
| 1891820312 | Mapleshade Vision Center Inc. | Optometrist | 11825 State Route 40, Suite 101, Dunlap, IL 61525-8842 | 2007-02-23 |
| 1265887210 | Jackson Sleep Centers Pllc | Dentist | 11825 State Route 40, Suite 100, Dunlap, IL 61525-8842 | 2016-04-27 |
| 1598141087 | Brockton Willey | Dentist | 11825 State Route 40, Dunlap, IL 61525-8842 | 2015-08-06 |
| Find all providers in zip 61525 | ||||
| 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 |
|---|---|---|---|---|
| 1023316460 | G&s Medical Equipment and Supply LLC | Durable Medical Equipment & Medical Supplies | 15166a Rankin Ave, Dunlap, TN 37327-7039 | 2011-03-09 |
| 1356524771 | Walgreen Co. | Durable Medical Equipment & Medical Supplies | 14857 Rankin Ave, Dunlap, TN 37327-1300 | 2007-12-07 |
| 1356406573 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 16773 Rankin Ave, Dunlap, TN 37327-7021 | 2006-12-27 |
| 1285709683 | Lincare Inc. | Durable Medical Equipment & Medical Supplies | 151 Cherry St, Ste B, Dunlap, TN 37327-3732 | 2006-11-21 |
| 1730272832 | Bi-lo, LLC. | Durable Medical Equipment & Medical Supplies | 428 Highway 28, Dunlap, TN 37327-3115 | 2006-10-02 |
| 1265541551 | Rite Aid of Tennessee Inc | Durable Medical Equipment & Medical Supplies | 14978 Rankin Avenue, Dunlap, TN 37327-7006 | 2006-08-30 |
| 1033636725 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 14978 Rankin Ave, Dunlap, TN 37327 | 2017-08-24 |
| 1225499080 | Bohannan Medical Dist., LLC | Durable Medical Equipment & Medical Supplies | 11417 N Boulder Creek Ct, Dunlap, IL 61525-1500 | 2016-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235730250 | Quantum Prosthetics & Orthotics | Durable Medical Equipment & Medical Supplies | 9050 W 81st St Ste 300, Justice, IL 60458-1350 | 2020-11-05 |
| 1164022901 | American Drug Stores LLC | Durable Medical Equipment & Medical Supplies | 10090 Route 47, Huntley, IL 60142 | 2020-10-30 |
| 1003415514 | Brandon M Hudson | Durable Medical Equipment & Medical Supplies | 185 N Franklin St Fl 3, Chicago, IL 60606-1932 | 2020-10-26 |
| 1538768882 | Elect Logistics LLC | Durable Medical Equipment & Medical Supplies | 1318 S 61st Ave, Cicero, IL 60804-1011 | 2020-10-19 |
| 1679170757 | Medical Service Companies | Durable Medical Equipment & Medical Supplies | 5201 Walnut Ave Ste 6, Downers Grove, IL 60515-4071 | 2020-10-02 |
| 1588271910 | Cell Store One1 Inc | Durable Medical Equipment & Medical Supplies | 3727 Highknob Cir, Naperville, IL 60564-4423 | 2020-09-29 |
| 1689281131 | Chloe Powell | Durable Medical Equipment & Medical Supplies | 307 W Park Dr Apt B, Belleville, IL 62226-4753 | 2020-09-29 |
| 1083220396 | Aeroflow Inc. | Durable Medical Equipment & Medical Supplies | 210 N Hammes Ave Ste 103a, Joliet, IL 60435-6688 | 2020-09-22 |
| 1568077212 | Du Page Medical Group Ltd | Durable Medical Equipment & Medical Supplies | 1206 East 9th Street, Ortho/spine Suite 103, Lockport, IL 60441-6044 | 2020-09-10 |
| 1295348084 | Windy City Rehab Specialists LLC | Durable Medical Equipment & Medical Supplies | 1530 S State St Ste C003, Chicago, IL 60605-2964 | 2020-08-31 |
| Find all providers with the same taxonomy | ||||
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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.