DR. DOUGLAS WARD (NPI# 1497782700) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497782700 |
| Entity Type | Individual |
| Full Name | DR. DOUGLAS WARD |
| Credential | M.D. |
| Practice Address |
2200 E Washington St Bloomington IL 61701-4364 |
| Mailing Address |
2538 Momentum Pl Chicago IL 60689-0001 |
| Practice Telephone | 3096615111 |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2009-07-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
036-100234 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036100234-2 | 05 | |
| IL | BC/BS | 05721369 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891195145 | Douglas R Ward | Behavioral Analyst | 664 Sedgewood Cir, Melbourne, FL 32904-8034 | 2014-08-23 |
| 1396830725 | Douglas J Ward | Internal Medicine | 1737 20th St, Nw, Washington, DC 20009 | 2006-10-03 |
| 1376518100 | Douglas Ward | Physician Assistant | 114 Woodland St, Department of Surgery, Hartford, CT 06105-1208 | 2006-02-23 |
| Street Address |
2200 E WASHINGTON ST |
| City | BLOOMINGTON |
| State | IL |
| Zip Code | 61701-4364 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750383139 | Liza M. Pilch | Emergency Medicine | 2200 E Washington St, Bloomington, IL 61701-4364 | 2005-08-15 |
| 1154930436 | Tianna Elaine Marie Nicholas | Nurse Practitioner | 2200 E Washington St, Bloomington, IL 61701-4364 | 2020-07-23 |
| 1063040004 | Bailey Wilson | Occupational Therapist | 2200 E Washington St, Bloomington, IL 61701-4364 | 2020-03-27 |
| 1679104624 | Mark Garbek | Physician Assistant | 2200 E Washington St, Bloomington, IL 61701-4364 | 2020-01-29 |
| 1326688870 | Shannon Colleen Trosper | Nurse Practitioner | 2200 E Washington St, Bloomington, IL 61701-4364 | 2020-01-13 |
| 1174174536 | Ivanna Tiffany Yu | Physician Assistant | 2200 E Washington St, Bloomington, IL 61701-4364 | 2019-09-26 |
| 1912564634 | Hanna Marguerite Cresci | Speech-Language Pathologist | 2200 E Washington St, Bloomington, IL 61701-4364 | 2019-05-29 |
| 1730654336 | Samantha Schuckles | Physical Therapist | 2200 E Washington St, Bloomington, IL 61701-4364 | 2018-10-10 |
| 1447758107 | Theresa M Hill | Nurse Practitioner | 2200 E Washington St, Bloomington, IL 61701-4364 | 2018-01-29 |
| 1821527201 | Jacob Peter Holton | Emergency Medicine | 2200 E Washington St, Bloomington, IL 61701-4364 | 2017-06-08 |
| Find all providers in the same location | ||||
| 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 | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689842262 | James Scott Frasure | Emergency Medicine | 4030 W Breezewood Ct, Bloomington, IN 47404-9132 | 2008-02-15 |
| 1982658886 | Robert L Goddard Jr. | Emergency Medicine | 817 W Rosewood Dr, Bloomington, IN 47404-1849 | 2006-05-22 |
| 1861703100 | The Vein Specialists, LLC | Emergency Medicine | 3302 Gerig Dr, Suite 100, Bloomington, IL 61704-6365 | 2010-07-01 |
| 1548340409 | Kevin T. Moore | Emergency Medicine | 601 W 2nd St, Bloomington, IN 47403-2317 | 2006-10-16 |
| 1841211042 | Jeanette Hammerstein | Emergency Medicine | 4011 S Monroe Medical Park Blvd, Bloomington, IN 47403-8000 | 2006-07-22 |
| 1023045606 | Richard Sabbun | Emergency Medicine | 2200 E Washington St, Bloomington, IL 61701-4364 | 2006-06-27 |
| 1851390504 | Joel Nelson | Emergency Medicine | 550 S Landmark Ave, Bloomington, IN 47403-3239 | 2005-07-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033760715 | Michael James Doolin | Emergency Medicine | 1338 S Clinton St, Chicago, IL 60607-5037 | 2019-09-24 |
| 1578091971 | The Board of Trustee for The University of Illinois | Emergency Medicine | 10000 West O'hare, Terminal 2, Chicago, IL 60660-0508 | 2017-05-30 |
| 1669712808 | Kathryn Theresa Pajak | Emergency Medicine | 5659 S Oak Park Ave, Chicago, IL 60638-3227 | 2013-02-26 |
| 1174832976 | Craig William Dean | Emergency Medicine | 155 N Harbor Dr Apt 309, Chicago, IL 60601-7386 | 2010-09-28 |
| 1770809881 | King, Ltd | Emergency Medicine | 9332 S Vanderpoel Ave, Chicago, IL 60643-5852 | 2010-04-14 |
| 1306098231 | Robert Dietz Tetik | Emergency Medicine | 2272 95th St Ste 106, Naperville, IL 60564-8942 | 2008-10-22 |
| 1831384643 | Primus Trauma Care LLC | Emergency Medicine | 1304 Franklin Avenue, Normal, IL 61761 | 2007-09-14 |
| 1245355411 | Pekin Memorial Hospital | Emergency Medicine | 600 So 13th Street, Pekin, IL 61554-4969 | 2007-03-20 |
| 1396879268 | Nanci A Cherry | Emergency Medicine | 7419 Bell Harbour Dr, Rockford, IL 61114-6600 | 2007-03-15 |
| 1972609782 | Jennifer Lynn Webb | Emergency Medicine | 15730 Robert Louis Dr, Plainfield, IL 60544-2146 | 2006-09-16 |
| Find all providers with the same taxonomy | ||||
| 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.