ST. MARYS HOSPITAL (NPI# 1699951483) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699951483 |
| Entity Type | Organization |
| Organization Name | ST. MARYS HOSPITAL |
| Other Organization Name | ST. MARY'S PRAIRIE CARDIOLOGY |
| Practice Address |
104 W 6th St Streator IL 61364-2899 |
| Practice Telephone | 8156728741 |
| Mailing Telephone | 8156728741 |
| Enumeration Date | 2008-01-11 |
| Last Update Date | 2008-12-10 |
| Authorized Official Name | KAREN S CLARK (CFO) |
| Authorized Official Telephone | 8156734514 |
| Is Organization Subpart | Y |
| Parent Organization Name | ST. MARY'S HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
36114675 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 220782977 | 05 | |
| IL | BLUE CROSS | 5032110 | 01 |
| MD NPI | 1669451233 | 01 |
| Other Name | Type Code |
|---|---|
| St. Mary's Prairie Cardiology | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154632735 | St. Marys Hospital | Hospitalist | 427 Guy Park Ave, Amsterdam, NY 12010-1054 | 2010-06-29 |
| Street Address |
104 W 6TH ST |
| City | STREATOR |
| State | IL |
| Zip Code | 61364-2899 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053319723 | Robert Parsons | Internal Medicine | 104 W 6th St, Ste 301, Streator, IL 61364-2899 | 2005-07-07 |
| 1720453202 | Streator Chidlrens Clinic | Specialist | 104 W 6th St, Suite 303, Streator, IL 61364-2899 | 2015-12-09 |
| 1770710360 | St Marys Hospital | Urology | 104 W 6th St, Streator, IL 61364-2899 | 2009-06-22 |
| 1164673307 | St Marys Hospital | Orthopaedic Surgery | 104 W 6th St, Streator, IL 61364-2899 | 2008-10-07 |
| 1578710562 | Rizwan S Ahmad | Surgery | 104 W 6th St, Suite 204, Streator, IL 61364-2899 | 2008-08-21 |
| 1568634806 | Bruce Sylvester Smith Md LLC | Specialist | 104 W 6th St, Suite 206, Streator, IL 61364-2899 | 2008-03-27 |
| 1114106242 | Peak Orthopaedic & Sports Caresc | Orthopaedic Surgery | 104 W 6th St, Streator, IL 61364-2899 | 2007-10-25 |
| 1669680112 | Caner Celeboglu Md Sc | Specialist | 104 W 6th St, Ste 204, Streator, IL 61364-2899 | 2007-05-18 |
| 1659586279 | Carl P Mattioda Md and Chaoming Chen Mdsc | Obstetrics & Gynecology | 104 W 6th St, Streator, IL 61364-2899 | 2007-05-14 |
| 1023166535 | Rosvida Anne B. San Gabriel | Pediatrics | 104 W 6th St, Suite 303, Streator, IL 61364-2899 | 2007-01-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093110066 | Ottawa Friendship House Work Activity Center, Inc | Intermediate Care Facility, Mentally Retarded | 600 West 12th Street, Streator, IL 61364 | 2014-11-03 |
| 1306278973 | Robert Henry Harms | Veterinarian | 701 Oakley Ave, Streator, IL 61364 | 2013-08-06 |
| 1518202373 | Jessica L Hartman | Nurse Practitioner | 2377 N Bloomington St, Streator, IL 61364 | 2012-12-05 |
| 1992049563 | Wendell Allen Sargent | Dentist | 106 Boys St, Streator, IL 61364 | 2012-11-20 |
| 1215266036 | Sudha Pravinkumar | Internal Medicine | 2377 Bloomington Ave, Ste B, Streator, IL 61364 | 2009-12-08 |
| 1497988984 | Lifetime Medical Supply Inc. | Durable Medical Equipment & Medical Supplies | 1215 N Ottercreek Rd., Streator, IL 61364 | 2009-08-31 |
| 1275709727 | Fresenius Medical Care of Illinois LLC | Clinic/Center | 2356 North Bloomington St, Streator, IL 61364 | 2008-05-05 |
| 1487701793 | Tammy R Thieme | Social Worker | 17 North Point Plaza, Streator, IL 61364 | 2007-01-05 |
| 1629185376 | Gary Finkelstein Md Eye Associates Sc | Ophthalmology | 102 West Elm Street, Streator, IL 61364 | 2006-08-25 |
| 1134150808 | Indra Pal Mdsc | Internal Medicine | 104 Sixth Street, Streator, IL 61364 | 2006-07-05 |
| Find all providers in zip 61364 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528596350 | Stat Cardiologist Inc | Internal Medicine | 2425 W 22nd St Ste 209, Oak Brook, IL 60523-4655 | 2017-05-24 |
| 1306296074 | Safwan Gaznabi | Internal Medicine | Northshore University Healthsystem, Office of Academic Affairs 2650 Ridge Ave., Suite 1304, Evanston, IL 60201 | 2016-06-14 |
| 1154796290 | Ray Jean Pensinger | Internal Medicine | 105 S. Fleming Rd., Woodstock, IL 60098-7903 | 2015-12-01 |
| 1073905311 | Cardio Medical Center Sc | Internal Medicine | 7746 West Madison Ave, Forrest Park, IL 60131 | 2015-02-24 |
| 1427457399 | Charles Joseph Frahm | Internal Medicine | 1200 E Madison Park, Chicago, IL 60615-2961 | 2014-08-17 |
| 1225447725 | Jeremy R. Estrada | Internal Medicine | 5841 S Maryland Ave # Mc5841, Chicago, IL 60637-1447 | 2014-08-08 |
| 1285049197 | Nidhi Madan | Internal Medicine | 1717 W Congress Pkwy Ste 317, Chicago, IL 60612 | 2014-06-30 |
| 1295159184 | Ca Group, LLC | Internal Medicine | 4017 Illinois Route 159, Suite 101, Smithton, IL 62285 | 2014-02-12 |
| 1457788424 | Chicago Vascular Clinic Ltd | Internal Medicine | 812 E Woodfield Rd, Schaumburg, IL 60173-4714 | 2013-10-04 |
| 1942634688 | Vein Md Consultants, LLC | Internal Medicine | 1865 N. Eltnor Blvd., West Chicago, IL 60185-5900 | 2013-08-29 |
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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.