DR. JAMES J PAVLOVICH (NPI# 1679686745) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679686745 |
| Entity Type | Individual |
| Full Name | DR. JAMES J PAVLOVICH |
| Credential | M.D. |
| Practice Address |
6294 State Highway 154 Sesser IL 62884 |
| Mailing Address |
Po Box 155 Christopher IL 62822-0155 |
| Practice Telephone | 6186256979 |
| Mailing Telephone | 6187241624 |
| Mailing Fax Number | 6187244628 |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2019-06-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 036089862 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | GHP | 324148 | 01 |
| IL | HAMP INSURANCE NUMBER | 027538 | 01 |
| IL | 036089862 | 05 | |
| IL | AETNA | 7210895 | 01 |
| IL | HEALTHLINK | 271458 | 01 |
| IL | BCBS OF IL | 3932056 | 01 |
| IL | GHP INSURANCE NUMBER | 48175 | 01 |
| IL | RR MEDICARE NUMBER | 370007818 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2601 W Main St, Carbondale, IL 629011031 | 6185495361 | 6185495128 |
| Street Address |
6294 STATE HIGHWAY 154 |
| City | SESSER |
| State | IL |
| Zip Code | 62884 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487271557 | Megan Nicole Plummer | Nurse Practitioner | 6294 State Highway 154, Sesser, IL 62884-2163 | 2020-07-06 |
| 1720550643 | Ashley Lynn Agnew | Licensed Practical Nurse | 6294 State Highway 154, Sesser, IL 62884-2163 | 2018-12-18 |
| 1457821423 | Rachel Lynn Sullivan | Registered Nurse | 6294 State Highway 154, Sesser, IL 62884-2163 | 2018-12-03 |
| 1053886036 | Toni K Owens | Registered Nurse | 6294 State Highway 154, Sesser, IL 62884-2163 | 2018-10-05 |
| 1932686987 | Jilissa M Payne | Dental Hygienist | 6294 State Highway 154, Sesser, IL 62884-2163 | 2018-07-23 |
| 1366967234 | Olivia Dalby | Registered Nurse | 6294 State Highway 154, Sesser, IL 62884-2163 | 2017-08-11 |
| 1417300120 | Michelle Cutrell | Licensed Practical Nurse | 6294 State Highway 154, Sesser, IL 62884-2163 | 2016-07-18 |
| 1881045110 | Patrick B Cameron | Dentist | 6294 State Highway 154, Sesser, IL 62884-2163 | 2016-06-28 |
| 1285081224 | Sesser Pharmacy Si LLC | Pharmacy | 6294 State Highway 154, Suite A, Sesser, IL 62884-2163 | 2016-05-19 |
| 1144582974 | Deborah L. Hammonds | Registered Nurse | 6294 State Highway 154, Sesser, IL 62884-2163 | 2012-06-07 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093356362 | Pamela Miller | Technician | 602 West Florence Street, Sesser, IL 62884 | 2019-10-08 |
| 1669459129 | Julia A Bancroft | Family Medicine | 6294 State Hwy 154, Sesser, IL 62884 | 2005-12-27 |
| 1669429908 | Lee Peter Bee | Neuromusculoskeletal Medicine & OMM | 107 W Franklin St, Sesser, IL 62884-1456 | 2006-05-30 |
| 1134530173 | Southern Illinois Medical Specialists, LLC | Independent Medical Examiner | 107 W Franklin St, Sesser, IL 62884-1456 | 2014-05-13 |
| 1013351667 | Southern Illinois Medical Specialists, LLC | Emergency Medicine | 107 W Franklin St, Sesser, IL 62884-1456 | 2013-04-25 |
| 1699011882 | Franklin Hospital District | Clinic/Center | 107 W Franklin St, Sesser, IL 62884-1456 | 2012-12-17 |
| 1043582760 | Rhonda Lynn Hawkins | Dental Hygienist | 115 E Franklin St, Sesser, IL 62884-1814 | 2012-01-27 |
| 1821128208 | Sesser Valier Cud 196 | Local Education Agency (LEA) | 4626 State Highway 154, Sesser, IL 62884-2277 | 2007-03-06 |
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801494364 | Mebe Illinois | Pediatrics | 825 S Waukegan Rd Ste A8, Lake Forest, IL 60045-2665 | 2020-10-15 |
| 1326656125 | Kids Pediatrics Ltd | Pediatrics | 288 W Loop Rd, Wheaton, IL 60189-2034 | 2020-07-17 |
| 1922625672 | Tanya Montgomery Nee Brown | Pediatrics | 1950 West Polk Street, Neonatal and Perinatal Department, Chicago, IL 60612 | 2020-06-29 |
| 1780200865 | Kuang Chuen Liu | Pediatrics | 530 Ne Glen Oak Ave, Peoria, Peoria, IL 61637 | 2020-06-24 |
| 1487277596 | Kali Ann Kramolis | Pediatrics | 5841 S Maryland Ave Rm K155, Chicago, IL 60637-1443 | 2020-05-22 |
| 1578186839 | Katie Michelle Stapleton | Pediatrics | Osf St Francis Medical Center 530 Ne Glen Oak Avenue, Peoria, IL 61637-0001 | 2020-05-21 |
| 1467074492 | Kinnera Are | Pediatrics | 400 N 9th St Ste 4a, Springfield, IL 62702-5310 | 2020-05-13 |
| 1053932673 | Jain Pediatrics LLC | Pediatrics | 33 N Addison Rd Ste 106, Addison, IL 60101-3843 | 2020-05-05 |
| 1164050670 | Sruti Uppuluri | Pediatrics | 1675 Dempster St Ste 330, Park Ridge, IL 60068-1110 | 2020-03-30 |
| 1386272086 | Jane Bialek | Pediatrics | 5841 S Maryland Ave # Mc1502, Chicago, IL 60637-1443 | 2020-03-29 |
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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.