MRS. BERNADETTE KATHLENE SOBCZAK (NPI# 1649414558) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649414558 |
| Entity Type | Individual |
| Full Name | MRS. BERNADETTE KATHLENE SOBCZAK |
| Other Name | BERNADETTE KATHLENE MORDIS |
| Credential | C.P.N.P. PRIMARY CAR |
| Practice Address |
807 Broadway Gillespie IL 62033 |
| Practice Telephone | 2178393900 |
| Mailing Telephone | 2178393900 |
| Mailing Fax Number | 2178391313 |
| Enumeration Date | 2009-04-22 |
| Last Update Date | 2009-04-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
209-007531 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
807 BROADWAY |
| City | GILLESPIE |
| State | IL |
| Zip Code | 62033 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396244612 | Carlinville Area Hospital Assn | Clinic/Center | 807 Broadway, Gillespie, IL 62033-1100 | 2018-02-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225596950 | Laura Michelle Halpin | Physical Therapist | 607 Litchfield Road, Gillespie, IL 62033 | 2019-03-12 |
| 1770942716 | Carol Candler | Nurse Practitioner | 109 East Maple Street, Maucoupin County Maple Street Clinic, Gillespie, IL 62033 | 2016-02-18 |
| 1932519618 | Terry Allan | Pharmacist | 113 South Macoupin Street, Gillespie, IL 62033 | 2014-05-02 |
| 1376765206 | Sheri Lynne Banovic | Nurse Practitioner | 115 South Macoupin Street, Gillespie, IL 62033 | 2007-05-02 |
| 1215044920 | James Paul Verton | Pharmacist | 120 S Macoupin, Dippold Drug Co Inc, Gillespie, IL 62033 | 2006-08-25 |
| 1427575612 | Beth Lynn Sies | Speech-Language Pathologist | 340 Kelly St, Gillespie, IL 62033 | 2017-08-28 |
| 1356599971 | Julia Terese Ruckman | Social Worker | 109 E Maple St, Gillespie, IL 62033 | 2008-09-08 |
| 1124135835 | Bruce W Hughes | Pharmacist | 120 S Macoupin, Dippold Drug Co Inc, Gillespie, IL 62033 | 2006-08-25 |
| 1407474083 | Staten Family Practice Pllc | Clinic/Center | 500 W Virginia Ave, Gillespie, IL 62033-1025 | 2020-07-09 |
| 1639399157 | Therese Polo, Md, LLC | Pediatrics | 807 Broadway St, Gillespie, IL 62033-1100 | 2007-04-26 |
| Find all providers in zip 62033 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740881291 | Sarah Zeigler Olsen | Nurse Practitioner | 600 S Randall Rd Ste 220, Algonquin, IL 60102-5937 | 2020-11-02 |
| 1467051151 | Mallory Jo Brooks | Nurse Practitioner | 2306 E County Road 1800 N, Carthage, IL 62321-3101 | 2020-10-22 |
| 1508475294 | Diedra M Ahlert | Nurse Practitioner | 1320 Lexington Dr, Collinsville, IL 62234-4348 | 2020-07-28 |
| 1679182802 | Danielle L Shubert | Nurse Practitioner | 9423 Holy Cross Ln Ste 111, Breese, IL 62230-3510 | 2020-07-23 |
| 1154962900 | Janna Hoppe | Nurse Practitioner | 24600 W 127th St Ste 345, Plainfield, IL 60585-9507 | 2019-10-02 |
| 1841858529 | Katherine R Conkling | Nurse Practitioner | 4941 Benchmark Centre Dr Ste 100, Swansea, IL 62226-2038 | 2019-05-29 |
| 1942767280 | Danielle R Wetzel | Nurse Practitioner | 2040 Ogden Ave Ste 215, Aurora, IL 60504-7205 | 2019-02-22 |
| 1669937231 | Colleen Ann Larkin | Nurse Practitioner | 10939 S Troy St, Chicago, IL 60655-2211 | 2019-02-07 |
| 1568939684 | Katelyn Marie Reed | Nurse Practitioner | 415 N 9th St Ste 4w64, Springfield, IL 62702-5303 | 2018-10-26 |
| 1255813218 | Michelle Christine Bollinger | Nurse Practitioner | 415 N 9th St Ste 4w16, Springfield, IL 62702-5303 | 2018-09-05 |
| Find all providers with the same taxonomy | ||||
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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.