IMPACT PHYSICIAN GROUP, ILLINOIS, LLC (NPI# 1467920124) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467920124 |
| Entity Type | Organization |
| Organization Name | IMPACT PHYSICIAN GROUP, ILLINOIS, LLC |
| Practice Address |
115 E South St Ste F Plano IL 60545-1595 |
| Mailing Address |
21 Eastbrook Bnd Ste 218 Peachtree City GA 30269-1546 |
| Practice Telephone | 6305527166 |
| Mailing Telephone | 6789675599 |
| Enumeration Date | 2018-11-10 |
| Last Update Date | 2019-12-31 |
| Authorized Official Name | MR. PAUL MILLER (CEO) |
| Authorized Official Telephone | 6786994977 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
Allopathic & Osteopathic Physicians | ||
| N | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians | ||
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
115 E SOUTH ST STE F |
| City | PLANO |
| State | IL |
| Zip Code | 60545-1595 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598270035 | Thomas John Wade | Speech-Language Pathologist | 430 Mitchell Drive, Plano, IL 60545 | 2017-12-06 |
| 1902310857 | Jodi Sell | Speech-Language Pathologist | Pasec, 800 S Hale St, Plano, IL 60545 | 2017-11-29 |
| 1023161940 | William Yaw-ntaaku Asihene | Surgery | 12700 Us Highway 34, Plano, IL 60545 | 2007-01-22 |
| 1609941319 | Jose G Trevino Sr. | Registered Nurse | 1200 W South St, Plano, IL 60545 | 2006-11-21 |
| 1134205586 | John A Gordon Jr. | Dentist | 901 West Route 34, Suite 103, Plano, IL 60545 | 2006-10-28 |
| 1104853902 | Snehal K Kulkarni | Audiologist | 11000 E. Rt 34, Ste 3, Plano, IL 60545 | 2006-06-27 |
| 1376640730 | Riverglen Ear, Nose & Throat and Audiology, LLC | Otolaryngology | 11000 E. Rt 34, Ste 3, Plano, IL 60545 | 2006-09-20 |
| 1508920828 | Thomas W. Barney | Chiropractor | 200 S. Hale St., Ste. 2, Plano, IL 60545-0188 | 2006-12-21 |
| 1861524233 | Nancy Lynn Reiland | Occupational Therapist | 2009 Bittersweet Dr, Plano, IL 60545-1066 | 2007-03-12 |
| 1407031065 | Reiland Therapy Services, P.C. | Occupational Therapist | 2009 Bittersweet Dr, Plano, IL 60545-1066 | 2008-01-02 |
| Find all providers in zip 60545 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive 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 |
|---|---|---|---|---|
| 1902399926 | Your Health Diagnostics LLC | Internal Medicine | 5228 Village Creek Dr Ste 101, Plano, TX 75093-4431 | 2018-06-13 |
| 1821543208 | Vitality Weight Loss and Wellness Institute, Pllc | Internal Medicine | 2633 Dallas Pkwy # 100, Plano, TX 75093-4703 | 2016-08-16 |
| 1609230812 | Ebony N. Raymond | Internal Medicine | 3105 W 15th St Ste E, Plano, TX 75075 | 2016-04-13 |
| 1386008167 | Love Wounds | Internal Medicine | 4416 Jenkins Dr, Plano, TX 75024-4817 | 2016-04-07 |
| 1578942546 | Omniphysicians, Pllc | Internal Medicine | 3000 Custer Rd Ste 270-507, Plano, TX 75075-4422 | 2015-05-24 |
| 1285022491 | Slalani Medico Service Pllc | Internal Medicine | 3408 Westwind Dr, Plano, TX 75093-7987 | 2014-12-23 |
| 1689062879 | Lone Medical Mht LLC | Internal Medicine | 1925 Edgewater Dr, Plano, TX 75075-8573 | 2014-12-23 |
| 1700283280 | Texas On Call Physicians PC | Internal Medicine | 3213 Twinfalls Dr, Plano, TX 75093-3331 | 2014-11-26 |
| 1487066114 | Pablo Andres Wunderlich Padilla | Internal Medicine | 4700 Alliance Blvd Ste 100, Plano, TX 75093-5323 | 2014-05-29 |
| 1629496336 | Tawfik A. Shabana | Internal Medicine | 4317 High Mesa Dr, Plano, TX 75093 | 2014-03-31 |
| Find all providers in PLANO | ||||
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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.