HOLLY LEIGH BROCKMAN (NPI# 1497907463) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497907463 |
| Entity Type | Individual |
| Full Name | HOLLY LEIGH BROCKMAN |
| Other Name | HOLLY LEIGH ELTREVOOG |
| Credential | M.D. |
| Practice Address |
747 N Rutledge St 5th Floor Springfield IL 62702-6700 |
| Mailing Address |
Po Box 19679 Springfield IL 62794-9679 |
| Practice Telephone | 2175458000 |
| Practice Fax Number | 2175451159 |
| Mailing Telephone | 2175458000 |
| Mailing Fax Number | 2175451159 |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2015-07-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 036-135677 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036135677 | 05 |
| Street Address |
747 N RUTLEDGE ST 5TH FLOOR |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62702-6700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619974532 | Neha N Amin | Obstetrics & Gynecology | 747 N Rutledge St, Baylis Building, 2nd Floor, Springfield, IL 62702-6700 | 2005-07-07 |
| 1295343648 | Katherine G Brockhouse | Nurse Practitioner | 747 N Rutledge St, Springfield, IL 62702-6700 | 2020-07-21 |
| 1376151258 | Lauren Woldanski | Plastic Surgery | 747 N Rutledge St, Springfield, IL 62702-6700 | 2020-07-16 |
| 1356968358 | Jessie Laina Koljonen | Plastic Surgery | 747 N Rutledge St, Springfield, IL 62702-6700 | 2020-06-25 |
| 1487274882 | Tiffany Lynn Damm | Urology | 747 N Rutledge St, Springfield, IL 62702-6700 | 2020-04-26 |
| 1811516065 | Jazzmyne T Montgomery | Urology | 747 N Rutledge St, Springfield, IL 62702-6700 | 2020-04-08 |
| 1639738644 | Alexis Ruffolo | Plastic Surgery | 747 N Rutledge St, Springfield, IL 62702-6700 | 2019-06-12 |
| 1922667930 | Justin D Sawyer | Plastic Surgery | 747 N Rutledge St, Springfield, IL 62702-6700 | 2019-06-12 |
| 1174016950 | Michael Romanelli | Plastic Surgery | 747 N Rutledge St, Springfield, IL 62702-6700 | 2018-06-07 |
| 1902398357 | William James Bruce | Plastic Surgery | 747 N Rutledge St, Springfield, IL 62702-6700 | 2018-06-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457866519 | Mohammad Jamal Uddin Ansari | Internal Medicine | 751 N Rutledge St Ste 400, Springfield, IL 62702 | 2017-12-11 |
| 1588105811 | Mickey Graphia | Surgery | 701 N 1st St # D346, Springfield, IL 62702 | 2017-03-20 |
| 1376908913 | Abdul Hannan | Internal Medicine | 315 W Carpenter St # B, Springfield, IL 62702 | 2015-12-28 |
| 1871986414 | Rachel Hoselton | Nurse Practitioner | 400 N 9th St Fl 4, Springfield, IL 62702 | 2015-03-06 |
| 1548697774 | Alyssa Wilson | Behavioral Analyst | 232 Bruns Lane, One Sparcenter Plaza, Springfield, IL 62702 | 2013-10-02 |
| 1174965446 | Amy Wilson | Speech-Language Pathologist | 2120 West Washington Street, Springfield, IL 62702 | 2013-07-26 |
| 1275898116 | Pele Boutrous Dina | Pediatrics | 415 N 9th St # 4w16, Springfield, IL 62702 | 2012-07-06 |
| 1427327733 | Brook D Croke | Genetic Counselor, MS | 400 N. 9th Street, 3rd Floor Clinic B, Springfield, IL 62702 | 2011-12-16 |
| 1629352604 | Renae M Sanchez | Pharmacist | 3216 East Clearlake Ave, Springfield, IL 62702 | 2011-10-07 |
| 1982915302 | William Leland Zelkovich | Radiology | 701 N 1st, Springfield, IL 62702 | 2010-06-30 |
| Find all providers in zip 62702 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104440049 | Elliot M Johns | Orthopaedic Surgery | 301 N 8th St Ste 3a158, Springfield, IL 62701-1085 | 2020-06-06 |
| 1740804764 | David Alan Forgas | Orthopaedic Surgery | 901 N 1st St # D252, Springfield, IL 62702-3759 | 2020-06-05 |
| 1063849719 | Effingham Hospital, Inc. | Orthopaedic Surgery | 459 Highway 119 S Ste A, Springfield, GA 31329-3021 | 2013-09-26 |
| 1851646566 | Kenneth David Illingworth | Orthopaedic Surgery | 301 N 8th St Pav 3a158, Springfield, IL 62794 | 2012-07-18 |
| 1760792329 | Lasante Inc | Orthopaedic Surgery | 4936 Laverna Road, Springfield, IL 62707-9797 | 2010-10-18 |
| 1902134638 | Optim Orthopedics, LLC | Orthopaedic Surgery | 459 Highway 119 South, Springfield, GA 31329 | 2009-11-18 |
| 1861630113 | Acustep Diabetic Foot Center, LLC | Orthopaedic Surgery | 2139 W Republic Rd, Springfield, MO 65807-5705 | 2009-01-24 |
| 1902066491 | Charles Joseph Ash | Orthopaedic Surgery | 3433 I S Campbell, Springfield, MO 65807 | 2008-06-10 |
| 1366616849 | Jennie Garver | Orthopaedic Surgery | 300 Birnie Ave Ste 301, Springfield, MA 01107 | 2008-04-16 |
| 1841487733 | Maplegate Rehab Inc. Dba Medical Associates | Orthopaedic Surgery | 181 State St, Springfield, MA 01103-1719 | 2007-09-25 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62702 |
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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.