ILLINI MEDICAL ASSOCIATES, SC (NPI# 1578901930) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578901930 |
| Entity Type | Organization |
| Organization Name | ILLINI MEDICAL ASSOCIATES, SC |
| Practice Address |
390 Maple Summit Rd Jerseyville IL 62052-2000 |
| Practice Telephone | 6184982101 |
| Practice Fax Number | 6184988153 |
| Mailing Telephone | 6184982101 |
| Mailing Fax Number | 6184988153 |
| Enumeration Date | 2013-06-07 |
| Last Update Date | 2013-06-07 |
| Authorized Official Name | MS. SHERI A CLANTON (CBO MANAGER) |
| Authorized Official Telephone | 6184987518 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | 6701930001 | IL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | MEDICARE DME PTAN | 6701930001 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891034294 | Illini Medical Associates, Sc | Pediatrics | 1440 W Walnut St, Ste 2a, Jacksonville, IL 62650-1143 | 2013-02-05 |
| 1821383100 | Illini Medical Associates, Sc | Psychiatry & Neurology | 1170 Wall St, Suite 102, Jacksonville, IL 62650-4053 | 2011-06-14 |
| 1023143716 | Illini Medical Associates, Sc | Family Medicine | 205 S Morse St, Roodhouse, IL 62082-1322 | 2007-02-22 |
| Street Address |
390 MAPLE SUMMIT RD |
| City | JERSEYVILLE |
| State | IL |
| Zip Code | 62052-2000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326034919 | Srirama S Kurella | Internal Medicine | 390 Maple Summit Rd, Jerseyville, IL 62052-2000 | 2005-09-20 |
| 1700499274 | Carrie H Purdy | Nurse Practitioner | 390 Maple Summit Rd, Illini Bldg, Jerseyville, IL 62052 | 2020-08-25 |
| 1124579099 | Mary Beck | Nurse Practitioner | 390 Maple Summit Rd, Jerseyville, IL 62052 | 2016-10-17 |
| 1811392970 | Jersey Community Hospital | Clinic/Center | 390 Maple Summit Rd, Jerseyville, IL 62052-2000 | 2014-10-30 |
| 1598036071 | Krista E Jenkins | Physician Assistant | 390 Maple Summit Rd, Jerseyville, IL 62052-2000 | 2012-01-16 |
| 1023259967 | Victoria Ann Hargrave | Registered Nurse | 390 Maple Summit Rd, Jerseyville, IL 62052-2000 | 2009-03-22 |
| 1205090644 | Colleen M Canavan | Physician Assistant | 390 Maple Summit Rd, Jerseyville, IL 62052-2000 | 2008-07-15 |
| 1215062914 | Cynthia Barrett | Clinical Nurse Specialist | 390 Maple Summit Rd, Jerseyville, IL 62052-2000 | 2007-02-22 |
| 1053345488 | Deborah Marie Seymour | Nurse Practitioner | 390 Maple Summit Rd, Jerseyville, IL 62052-2000 | 2006-07-10 |
| 1013965698 | Illini Medical Associates Sc | Clinic/Center | 390 Maple Summit Rd, Jerseyville, IL 62052-2000 | 2006-05-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396265666 | Lauren Mccarthy | Podiatrist | 400 Maple Summit Rd Suite 200, Jerseyville, IL 62052 | 2017-06-27 |
| 1851757488 | German Insurance Agency | Local Education Agency (LEA) | 850 S State Street, Jerseyville, IL 62052 | 2016-01-12 |
| 1942584230 | Thomas G Honke | Pharmacist | 705 South State, Walgreens, Jerseyville, IL 62052 | 2011-10-05 |
| 1861786493 | Pain Relief Center | Clinic/Center | 903 South State Street, Jerseyville, IL 62052 | 2011-05-31 |
| 1902058845 | Ronald Lee Schroeder | Obstetrics & Gynecology | 1211 West Carpenter, Jerseyville, IL 62052 | 2008-10-22 |
| 1760696116 | Rebecca Elaine Alexander | Massage Therapist | 1301 S State St, Jerseyville, IL 62052 | 2007-05-09 |
| 1205950540 | Charles C Alexander | Chiropractor | 1301 S State, Jerseyville, IL 62052 | 2007-03-19 |
| 1902816358 | Kirk William Schultz | Chiropractor | 519 South State Street, Jerseyville, IL 62052 | 2006-08-08 |
| 1235119652 | Batool N Vali | Obstetrics & Gynecology | 1702 W. County Road, Jerseyville, IL 62052 | 2006-01-20 |
| 1649270729 | Jersey County Health Department | Public Health or Welfare | 1307 State Highway 109, Jerseyville, IL 62052 | 2005-07-29 |
| Find all providers in zip 62052 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942684287 | Highland Park Cvs LLC | Durable Medical Equipment & Medical Supplies | 303 S State St, Jerseyville, IL 62052-1852 | 2015-07-16 |
| 1104847375 | Walgreen Co. | Durable Medical Equipment & Medical Supplies | 705 S State St, Jerseyville, IL 62052-2340 | 2006-07-22 |
| 1437176799 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 1316 S State St, Jerseyville, IL 62052-3617 | 2006-07-16 |
| 1114915675 | Jerseyville Nursing and Reahbilitation Center, Inc | Durable Medical Equipment & Medical Supplies | 1001 S State St, Jerseyville, IL 62052-2361 | 2005-10-10 |
| 1710461777 | Jersey Community Hospital | Durable Medical Equipment & Medical Supplies | 400 Maple Summit Rd, Suite 100, Jerseyville, IL 62052-2028 | 2018-09-17 |
| 1154873537 | Anesthesia Services Associates, Pllc | Durable Medical Equipment & Medical Supplies | 903 S State St, Jerseyville, IL 62052-2344 | 2016-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235730250 | Quantum Prosthetics & Orthotics | Durable Medical Equipment & Medical Supplies | 9050 W 81st St Ste 300, Justice, IL 60458-1350 | 2020-11-05 |
| 1164022901 | American Drug Stores LLC | Durable Medical Equipment & Medical Supplies | 10090 Route 47, Huntley, IL 60142 | 2020-10-30 |
| 1003415514 | Brandon M Hudson | Durable Medical Equipment & Medical Supplies | 185 N Franklin St Fl 3, Chicago, IL 60606-1932 | 2020-10-26 |
| 1538768882 | Elect Logistics LLC | Durable Medical Equipment & Medical Supplies | 1318 S 61st Ave, Cicero, IL 60804-1011 | 2020-10-19 |
| 1679170757 | Medical Service Companies | Durable Medical Equipment & Medical Supplies | 5201 Walnut Ave Ste 6, Downers Grove, IL 60515-4071 | 2020-10-02 |
| 1588271910 | Cell Store One1 Inc | Durable Medical Equipment & Medical Supplies | 3727 Highknob Cir, Naperville, IL 60564-4423 | 2020-09-29 |
| 1689281131 | Chloe Powell | Durable Medical Equipment & Medical Supplies | 307 W Park Dr Apt B, Belleville, IL 62226-4753 | 2020-09-29 |
| 1083220396 | Aeroflow Inc. | Durable Medical Equipment & Medical Supplies | 210 N Hammes Ave Ste 103a, Joliet, IL 60435-6688 | 2020-09-22 |
| 1568077212 | Du Page Medical Group Ltd | Durable Medical Equipment & Medical Supplies | 1206 East 9th Street, Ortho/spine Suite 103, Lockport, IL 60441-6044 | 2020-09-10 |
| 1295348084 | Windy City Rehab Specialists LLC | Durable Medical Equipment & Medical Supplies | 1530 S State St Ste C003, Chicago, IL 60605-2964 | 2020-08-31 |
| Find all providers with the same taxonomy | ||||
| City | JERSEYVILLE |
| Zip Code | 62052 |
Please comment or provide details below to improve the information on ILLINI MEDICAL ASSOCIATES, SC.
| 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.