PREMIER MEDICAL GROUP, LLC (NPI# 1427357227) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1427357227 |
Entity Type | Organization |
Organization Name | PREMIER MEDICAL GROUP, LLC |
Other Organization Name | DRS. KULB, CHALIAN AND LEAK UROLOGY |
Practice Address |
1401 Eastland Dr Ste B Bloomington IL 61701-3514 |
Practice Telephone | 3096639424 |
Practice Fax Number | 3096636350 |
Mailing Telephone | 3096639424 |
Mailing Fax Number | 3096636350 |
Enumeration Date | 2011-03-18 |
Last Update Date | 2011-03-18 |
Authorized Official Name | JOHN HESSE (EXECUTIVE DIRECTOR) |
Authorized Official Telephone | 3096626200 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 208800000X | Urology | Allopathic & Osteopathic Physicians |
Other Name | Type Code |
---|---|
Drs. Kulb, Chalian and Leak Urology | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639468788 | Premier Medical Group, LLC | Obstetrics & Gynecology | 1505 Eastland Dr Ste 500, Bloomington, IL 61701-7905 | 2011-03-29 |
1942501978 | Premier Medical Group, LLC | Family Medicine | 2102 E Washington St, Bloomington, IL 61701-4321 | 2010-11-08 |
1275825432 | Premier Medical Group, LLC | Orthopaedic Surgery | 2005 Jacobssen Dr, Suite A, Normal, IL 61761-6287 | 2011-05-06 |
1184913881 | Premier Medical Group, LLC | Obstetrics & Gynecology | 1300 Franklin Ave, Suite 360, Normal, IL 61761-3592 | 2011-04-04 |
1891084653 | Premier Medical Group, LLC | Obstetrics & Gynecology | 107 N Regency Dr, Bloomington, IL 61701-3505 | 2011-04-01 |
1841589835 | Premier Medical Group, LLC | Internal Medicine | 1302 Franklin Ave, #4800, Normal, IL 61761-3551 | 2011-03-31 |
1720377690 | Premier Medical Group, LLC | Surgery | 1537 Fort Jesse Rd, Suite A, Normal, IL 61761-6192 | 2011-03-31 |
1487943593 | Premier Medical Group, LLC | Plastic Surgery | 1505 Eastland Dr, Suite 350, Bloomington, IL 61701-3534 | 2011-03-30 |
1497054720 | Premier Medical Group, LLC | Podiatrist | 1512 W Reynolds St Ste A, Pontiac, IL 61764-9788 | 2011-03-25 |
1992004683 | Premier Medical Group, LLC | Surgery | 1505 Eastland Dr, Suite 2300, Bloomington, IL 61701-3534 | 2011-03-21 |
Street Address |
1401 EASTLAND DR STE B |
City | BLOOMINGTON |
State | IL |
Zip Code | 61701-3514 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770140964 | County of Mclean | Community/Behavioral Health | 200 W Front St, 1st Floor Sw, C/o 200 W Front St, Suite 400f, Bloomington, IL 61701 | 2019-05-22 |
1023525292 | Karli Johnson | Counselor | 200 W Monroe St Ste C7, Bloomington, IL 61701 | 2018-01-09 |
1487172409 | Melody Ann Bauman | Physician Assistant | 1505 Eastland Dr, Osf Critical Cane, Pulmonary, Sleep M, Bloomington, IL 61701 | 2017-08-30 |
1215396288 | Heidi Larsen | Social Worker | 902 S East St, Bloomington, IL 61701 | 2016-02-18 |
1558735126 | Andrea E. Andrews Counseling LLC | Counselor | 200 W. Monroe St., Ste 302 C, Bloomington, IL 61701 | 2015-11-19 |
1174924856 | Carole Hahn | Dietitian, Registered | 1406 Forrest St, Bloomington, IL 61701 | 2014-09-12 |
1558786392 | Valerie Colleen Parker | Counselor | 109 W. Mulberry St., Bloomington, IL 61701 | 2014-03-04 |
1124459219 | Matilde Francois | Surgery | 1505 Eastland Dr Ste 2300, Bloomington, IL 61701 | 2013-11-27 |
1922435114 | Smitha H Shivaprasad | Pharmacist | 2611 East Oakland Avenue, Bloomington, IL 61701 | 2013-10-02 |
1295161941 | Ashvin Patel | Obstetrics & Gynecology | 31 Country Club Pl, Bloomington, IL 61701 | 2013-09-25 |
Find all providers in zip 61701 |
Taxonomy Code | 208800000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Urology |
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710112271 | Michael Andrew Surian | Urology | 880 Woodcrest Drive, Bloomington, IN 47401 | 2009-05-27 |
1083608335 | Timothy A Habbe | Urology | 2907 Mcintyre Dr, Bloomington, IN 47403-4209 | 2005-09-01 |
1659379535 | Warren L Gray | Urology | 2907 Mcintyre Dr., Bloomington, IN 47403-4224 | 2005-07-13 |
1467450767 | Brian J Logue | Urology | 2907 S Mcintire Dr, Bloomington, IN 47403-4224 | 2005-07-11 |
1578940151 | Ashley Shumate | Urology | 1520 S Liberty Dr, Bloomington, IN 47403-5167 | 2015-05-02 |
1790075596 | Amanda Jean Pettibone-pond | Urology | 1520 S Liberty Dr, Bloomington, IN 47403-5167 | 2011-04-13 |
1548427123 | Paula J Bunde | Urology | 1520 S Liberty Dr, Bloomington, IN 47403-5167 | 2008-05-21 |
1831215391 | Urologic Surgery Associates, S.c. | Urology | 1414 Woodbine Rd, Bloomington, IL 61704-2817 | 2007-03-22 |
1003912726 | Dean L Lenz | Urology | 1520 S Liberty Dr, Bloomington, IN 47403-5167 | 2006-09-16 |
1972522720 | Daniel Lange | Urology | 1701 E College Ave, Bloomington, IL 61704-2101 | 2006-07-19 |
Find all providers in BLOOMINGTON |
City | BLOOMINGTON |
Zip Code | 61701 |
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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.