PREMIER MEDICAL GROUP, LLC (NPI# 1467751156) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467751156 |
| Entity Type | Organization |
| Organization Name | PREMIER MEDICAL GROUP, LLC |
| Other Organization Name | MID-CENTRAL ILLINOIS GASTROENTEROLOGY, LTD. |
| Practice Address |
2200 Jacobssen Dr Suite B Normal IL 61761-5516 |
| Practice Telephone | 3094511123 |
| Practice Fax Number | 3094511212 |
| Mailing Telephone | 3094511123 |
| Mailing Fax Number | 3094511212 |
| Enumeration Date | 2011-03-21 |
| Last Update Date | 2011-03-21 |
| Authorized Official Name | MR. JOHN HESSE (EXECUTIVE ADMINISTRATOR) |
| Authorized Official Telephone | 3096626200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
IL | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Mid-Central Illinois Gastroenterology, Ltd. | 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 |
| 1427357227 | Premier Medical Group, LLC | Urology | 1401 Eastland Dr Ste B, Bloomington, IL 61701-3514 | 2011-03-18 |
| 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 |
| Street Address |
2200 JACOBSSEN DR SUITE B |
| City | NORMAL |
| State | IL |
| Zip Code | 61761-5516 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134228224 | Stephen S Matter | Internal Medicine | 2200 Jacobssen Dr, Normal, IL 61761-5516 | 2006-09-22 |
| 1992845358 | Mid-central Ill Gastro | Internal Medicine | 2200 Jacobssen Dr, Suite B, Normal, IL 61761-5516 | 2007-02-07 |
| 1174670723 | Gastrointestinal Institute, LLC. | Clinic/Center | 2200 Jacobssen Dr, Suite A, Normal, IL 61761-5516 | 2007-01-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629681796 | Brittany Nicole Mekley | Nurse Practitioner | 201 N. University, Normal, IL 61761 | 2020-08-28 |
| 1679108971 | Krystal Halliday | Occupational Therapist | 1815 N Towanda Barnes Rd, Normal, IL 61761 | 2020-03-06 |
| 1265915474 | Laine E Burek | Nurse Practitioner | 1765 Bradford Ln., Normal, IL 61761 | 2018-09-13 |
| 1801389986 | Ashley Michelle James | Specialist/Technologist | 347 S. University St, Normal, IL 61761 | 2018-06-12 |
| 1447750708 | Shelley R. Ruch | Specialist/Technologist, Other | 1604 Visa Drive, Ste 1, Normal, IL 61761 | 2018-02-13 |
| 1497275069 | Mclean County Nursing Home | Non-emergency Medical Transport (VAN) | 901 N. Main St, Normal, IL 61761 | 2017-06-23 |
| 1235673666 | Megan Threm | Registered Nurse | 900 Franklin Ave Community Health Care Clinic, Normal, IL 61761 | 2016-12-04 |
| 1437513553 | Tiesha Smith | Specialist | 1800 Rockingham Dr, Apt 1d, Normal, IL 61761 | 2016-04-06 |
| 1285031658 | New Day Recovery | Community/Behavioral Health | 402 Summit, Normal, IL 61761 | 2014-12-01 |
| 1174927701 | Alyssa Marie Bruck | Occupational Therapist | 700 N Walnut St, Normal, IL 61761 | 2014-10-10 |
| Find all providers in zip 61761 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134228224 | Stephen S Matter | Internal Medicine | 2200 Jacobssen Dr, Normal, IL 61761-5516 | 2006-09-22 |
| 1164475877 | Vijay Laxmi Misra | Internal Medicine | 1302 Franklin Ave Ste 4800, Normal, IL 61761-3595 | 2006-05-17 |
| 1841589835 | Premier Medical Group, LLC | Internal Medicine | 1302 Franklin Ave, #4800, Normal, IL 61761-3551 | 2011-03-31 |
| 1992845358 | Mid-central Ill Gastro | Internal Medicine | 2200 Jacobssen Dr, Suite B, Normal, IL 61761-5516 | 2007-02-07 |
| 1770506651 | Herbert Wiser | Internal Medicine | 1302 Franklin Ave, #4800, Normal, IL 61761 | 2006-07-25 |
| 1033147848 | Kenneth Schoenig | Internal Medicine | 1302 Franklin Ave, #4800, Normal, IL 61761 | 2006-06-29 |
| 1306874102 | Digestive Disease Consultants Ltd | Internal Medicine | 1302 Franklin Ave, #4800, Normal, IL 61761 | 2006-06-29 |
| 1073560751 | Thomas Deweert | Internal Medicine | 1302 Franklin Ave, #4800, Normal, IL 61761 | 2006-05-28 |
| 1669429379 | Philip Koszyk | Internal Medicine | 1302 Franklin Ave, #4800, Normal, IL 61761 | 2006-05-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013487388 | Endoscopy Center of The North Shore, LLC | Internal Medicine | 1100 Central Ave Ste H, Wilmette, IL 60091-2666 | 2018-11-29 |
| 1104303296 | Amanda Israel | Internal Medicine | 5841 S Maryland Ave # 4076m410, Chicago, IL 60637-1443 | 2018-07-23 |
| 1861999559 | Kiba, Inc. | Internal Medicine | 3845 Mccoy Dr Ste 101, Aurora, IL 60504-4429 | 2018-04-09 |
| 1447765888 | David Henoch Barch | Internal Medicine | 3431 N Leavitt St, Chicago, IL 60618-6013 | 2017-12-07 |
| 1861861403 | Belleville Endoscopy LLC | Internal Medicine | 311 West Lincoln St, Suite 101, Belleville, IL 62220 | 2015-09-24 |
| 1205218658 | Ye Eun Kwak | Internal Medicine | 5841 S Maryland Ave Rm J-517, Chicago, IL 60637 | 2015-06-22 |
| 1699186890 | Laura Hamad | Internal Medicine | 1717 Midwest Club Pkwy, Oak Brook, IL 60523-2586 | 2014-05-11 |
| 1154749042 | Joshua Michael Steinberg | Internal Medicine | 5841 S Maryland Ave # 4076, Chicago, IL 60637-1443 | 2014-03-28 |
| 1841533254 | Danish Shahab | Internal Medicine | 133 E Brush Hill Rd Ste 100&400, Elmhurst, IL 60126-5659 | 2013-04-03 |
| 1447599311 | Seymour Marshall Sabesin | Internal Medicine | 630 S Hermitage Ave, Suite 802, Chicago, IL 60612-3874 | 2013-02-12 |
| 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.