SARAH BUSH LINCOLN HEALTH CENTER (NPI# 1508984642) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508984642 |
| Entity Type | Organization |
| Organization Name | SARAH BUSH LINCOLN HEALTH CENTER |
| Other Organization Name | SBL OTOLARYNGOLOGY |
| Practice Address |
500 Health Center Dr Mattoon IL 61938-9258 |
| Mailing Address |
1000 Health Center Dr Mattoon IL 61938-9253 |
| Practice Telephone | 2172582409 |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2007-07-18 |
| Authorized Official Name | MR. DENNIS PLUARD (CFO) |
| Authorized Official Telephone | 2172582513 |
| Is Organization Subpart | Y |
| Parent Organization Name | SARAH BUSH LINCOLN HEALTH CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| SBL Otolaryngology | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386283455 | Sarah Bush Lincoln Health Center | Durable Medical Equipment & Medical Supplies | 1611 Veterans Ave Ste T, Vandalia, IL 62471-3303 | 2020-01-06 |
| 1467951699 | Sarah Bush Lincoln Health Center | Durable Medical Equipment & Medical Supplies | 903 N Maple St, Effingham, IL 62401 | 2018-02-02 |
| 1215436449 | Sarah Bush Lincoln Health Center | Durable Medical Equipment & Medical Supplies | 300 Coles Centre Pkwy, Mattoon, IL 61938 | 2018-02-02 |
| 1346368487 | Sarah Bush Lincoln Health Center | Pediatrics | 1411 E St, Suite 2, Charleston, IL 61920-2529 | 2007-03-27 |
| 1528186665 | Sarah Bush Lincoln Health Center | Clinic/Center | 934 North Route 49, Casey, IL 62420 | 2007-03-27 |
| 1467570507 | Sarah Bush Lincoln Health Center | Family Medicine | 200 Professional Plz, Mattoon, IL 61938-9280 | 2007-03-27 |
| 1386762425 | Sarah Bush Lincoln Health Center | Family Medicine | 104 Courthouse Square, Toledo, IL 62468 | 2007-03-27 |
| 1588782627 | Sarah Bush Lincoln Health Center | Family Medicine | 1005 Health Center Drive, Suite 103, Prairie Pavilion I, Mattoon, IL 61938-4693 | 2007-03-27 |
| 1083732630 | Sarah Bush Lincoln Health Center | Family Medicine | 241 W Springfield Rd, Arcola, IL 61910-1202 | 2007-03-26 |
| 1922190024 | Sarah Bush Lincoln Health Center | Home Health | 1004 Health Center Dr, Suite 202, Mattoon, IL 61938-9253 | 2006-09-28 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SARAH BUSH LINCOLN HEALTH CENTER | 1000 Health Center Dr, Mattoon, IL 61938-9253 |
| Street Address |
500 HEALTH CENTER DR |
| City | MATTOON |
| State | IL |
| Zip Code | 61938-9258 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275525701 | Carl R Johnson | Internal Medicine | 500 Health Center Dr, Suite 104, Mattoon, IL 61938-9258 | 2005-08-19 |
| 1740400597 | Sarah Bush Lincoln Health Center | Clinic/Center | 500 Health Center Dr, Suite 406, Mattoon, IL 61938-9258 | 2007-04-26 |
| 1861510901 | Sarah Bush Lincoln Health Center | Internal Medicine | 500 Health Center Dr, Suite 302, Mattoon, IL 61938-9258 | 2007-03-27 |
| 1770601817 | Sarah Bush Lincoln Health Center | Internal Medicine | 500 Health Center Dr, Suite 401, Mattoon, IL 61938-9258 | 2007-03-27 |
| 1689792723 | Sarah Bush Lincoln Health Center | Neurological Surgery | 500 Health Center Dr, Mattoon, IL 61938-9258 | 2007-03-27 |
| 1497873533 | Sarah Bush Lincoln Health Center | Orthopaedic Surgery | 500 Health Center Dr, Suite 101, Mattoon, IL 61938-9258 | 2007-03-27 |
| 1124146261 | Sarah Bush Lincoln Health Center | Pain Medicine | 500 Health Center Dr, Mattoon, IL 61938-9258 | 2007-03-27 |
| 1396863437 | Sarah Bush Lincoln Health Center | Pediatrics | 500 Health Center Dr, Suite 208, Mattoon, IL 61938-9258 | 2007-03-27 |
| 1477671519 | Sarah Bush Lincoln Health Center | Surgery | 500 Health Center Dr, Suite 301, Mattoon, IL 61938-9258 | 2007-03-27 |
| 1558489690 | Sarah Bush Lincoln Health Center | Obstetrics & Gynecology | 500 Health Center Dr, Suite 201, Mattoon, IL 61938-9258 | 2007-03-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043831134 | St Anthony's Memorial Hospital of The Hospital Sisters of The Third Or | Clinic/Center | 101 Coles Centre Pkwy, Ste 101, Mattoon, IL 61938 | 2020-04-30 |
| 1215436449 | Sarah Bush Lincoln Health Center | Durable Medical Equipment & Medical Supplies | 300 Coles Centre Pkwy, Mattoon, IL 61938 | 2018-02-02 |
| 1841707726 | Mattoon Chiropractic LLC | Chiropractor | 905 Remington Rd, Mattoon, IL 61938 | 2018-01-02 |
| 1164892758 | Dr. Charles L. Schnibben Ltd. | Dentist | 1502 Lakeland Blvd, Mattoon, IL 61938 | 2015-09-25 |
| 1982000139 | Judy A. Clark | Hearing Instrument Specialist | 1302 Charleston Avenue, Audibel Hearing Aids, Mattoon, IL 61938 | 2014-11-17 |
| 1023419884 | Christopher Steven Lillie | Physician Assistant | 200 Richmond Ave East, Family Medical Center, Mattoon, IL 61938 | 2014-09-11 |
| 1295055168 | Jennifer Harp | Mechanotherapist | 232 Richmond Ave East, Mattoon, IL 61938 | 2010-06-02 |
| 1447482682 | Gene Clark Hearing Aid Service | Hearing Aid Equipment | 208 Wabash, Mattoon, IL 61938 | 2009-08-21 |
| 1326229774 | Central Illinois Family Health Center | Nurse Practitioner | 10555 East County Rd 800 North, Mattoon, IL 61938 | 2007-11-14 |
| 1568656445 | Bernie Ranchero | Family Medicine | 1004 Health Center Dr Ste 210, Mattoon, IL 61938 | 2007-09-04 |
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| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| 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 Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861508665 | Charly Nguyen | Otolaryngology | 1000 Health Center Dr Ste 401, Mattoon, IL 61938-9253 | 2006-08-22 |
| 1003037169 | Lori Cudone | Otolaryngology | 1000 Health Center Dr Ste 401, Mattoon, IL 61938-9253 | 2007-05-02 |
| 1215043971 | Michael Smith | Otolaryngology | 1000 Health Center Dr Ste 401, Mattoon, IL 61938 | 2006-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841838109 | Ryan C. Vaughn, Md Pllc | Otolaryngology | 1900 E Golf Rd Ste L125, Schaumburg, IL 60173-5831 | 2019-12-18 |
| 1265074934 | Toriumi Facial Plastics Pllc | Otolaryngology | 60 E Delaware Pl Ste 1425, Chicago, IL 60611-1998 | 2019-10-14 |
| 1184281735 | Advanced Ear Nose & Throat Specialists, Pllc | Otolaryngology | 925 N Milwaukee Ave Unit 200, Vernon Hills, IL 60061-1637 | 2019-05-20 |
| 1780144402 | Veronica Maria Drozdowski | Otolaryngology | 2160 S 1st Ave Rm 1870, Maywood, IL 60153-3328 | 2019-03-20 |
| 1205395019 | Brian Yuhan | Otolaryngology | 2160 S 1st Ave Bldg 105, Maywood, IL 60153-3328 | 2019-03-19 |
| 1285100529 | Lauren E Lesniewski | Otolaryngology | 680 N Lake Shore Dr Ste 1210, Chicago, IL 60611-4490 | 2018-10-14 |
| 1982100525 | Muyinat Yewande Osoba | Otolaryngology | 675 N. Saint Clair St, Galter Pavilion, 15th Floor, Room 200, Chicago, IL 60611-5975 | 2018-04-03 |
| 1851811343 | Peter S Dumich | Otolaryngology | 2609 S Nottingham Ct, Champaign, IL 61821-6182 | 2017-06-26 |
| 1104354414 | Sara M. Wing | Otolaryngology | 301 N 8th St Ste 5b, Springfield, IL 62701-1041 | 2017-05-31 |
| 1750734778 | Darius Bliznikas Md Sc | Otolaryngology | 7110 W 127th St Ste 210, Palos Heights, IL 60463-1580 | 2016-07-14 |
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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.