RICHLAND MEMORIAL HOSPITAL, INC (NPI# 1700063179) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700063179 |
| Entity Type | Organization |
| Organization Name | RICHLAND MEMORIAL HOSPITAL, INC |
| Practice Address |
800 E Locust St Olney IL 62450-2553 |
| Mailing Address |
Po Box 97 Olney IL 62450-0097 |
| Practice Telephone | 6183957340 |
| Mailing Telephone | 6183957340 |
| Enumeration Date | 2008-01-28 |
| Last Update Date | 2018-05-09 |
| Authorized Official Name | HARRY BROCKUS (CEO) |
| Authorized Official Telephone | 2172838540 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 036060342 | IL | Allopathic & Osteopathic Physicians |
| N | 208800000X | Urology | 036119328 | IL | Allopathic & Osteopathic Physicians |
| N | 363L00000X | Nurse Practitioner | 209004125 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 207Y00000X | Otolaryngology | 036050750 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE SHIELD | 08022315 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104093590 | Richland Memorial Hospital, Inc | Otolaryngology | 76 W Airline Dr, East Alton, IL 62024-1681 | 2008-05-14 |
| 1235790940 | Richland Memorial Hospital, Inc | Durable Medical Equipment & Medical Supplies | 108 S Main St, West Salem, IL 62476-1202 | 2019-06-24 |
| 1952961997 | Richland Memorial Hospital, Inc | Pharmacy | 108 S Main St, West Salem, IL 62476-1202 | 2019-06-20 |
| 1326566290 | Richland Memorial Hospital, Inc | Clinic/Center | 605 E Main St, Olney, IL 62450-2163 | 2017-08-31 |
| 1508932096 | Richland Memorial Hospital, Inc | General Acute Care Hospital | 800 E Locust St, Olney, IL 62450-2553 | 2006-11-27 |
| 1740224344 | Richland Memorial Hospital, Inc | Skilled Nursing Facility | 800 E Locust St, Olney, IL 62450-2553 | 2006-06-15 |
| 1821032525 | Richland Memorial Hospital, Inc | Medicare Defined Swing Bed Unit | 800 E Locust St, Olney, IL 62450-2553 | 2006-06-15 |
| 1467492124 | Richland Memorial Hospital, Inc | General Acute Care Hospital | 800 E Locust St, Olney, IL 62450-2553 | 2006-06-08 |
| 1528014834 | Richland Memorial Hospital, Inc | Psychiatric Hospital | 800 E Locust St, Olney, IL 62450-2553 | 2006-05-26 |
| Street Address |
800 E LOCUST ST |
| City | OLNEY |
| State | IL |
| Zip Code | 62450-2553 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649252511 | Paul W Sutherland | Surgery | 800 E Locust St, Olney, IL 62450-2553 | 2005-11-16 |
| 1174142665 | Samantha A Lewis | Speech-Language Pathologist | 800 E Locust St, Olney, IL 62450-2553 | 2020-04-14 |
| 1972132991 | Clinton David Rauch | Occupational Therapist | 800 E Locust St, Olney, IL 62450-2553 | 2020-04-02 |
| 1629607544 | Ladi Stallard | Physical Therapist | 800 E Locust St, Olney, IL 62450-2553 | 2020-04-02 |
| 1770111999 | Kelsey Lynn Runyon | Physical Medicine & Rehabilitation | 800 E Locust St, Olney, IL 62450-2553 | 2020-04-01 |
| 1801424957 | Katrina Williams | Occupational Therapist | 800 E Locust St, Olney, IL 62450-2553 | 2020-04-01 |
| 1700414877 | Whitley Dawn Houchin | Physical Medicine & Rehabilitation | 800 E Locust St, Olney, IL 62450-2553 | 2020-04-01 |
| 1073143475 | Arrow Ambulance, LLC | Ambulance | 800 E Locust St, Olney, IL 62450-2553 | 2020-01-24 |
| 1003452095 | Shay N Farris | Physical Medicine & Rehabilitation | 800 E Locust St, Olney, IL 62450-2553 | 2019-11-25 |
| 1043861883 | Kelsie Ann Harper | Occupational Therapist | 800 E Locust St, Olney, IL 62450-2553 | 2019-09-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851530091 | Donna Harris | Counselor | 515 West St. John Street, Olney, IL 62450 | 2009-02-11 |
| 1942476908 | Christa Dawn Jennette | Private Vehicle | 1113 Keiffer Dr, Olney, IL 62450 | 2008-04-30 |
| 1942491162 | Marion County Horizon Center D/b/a Richland Manor | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1066 West Main St, Olney, IL 62450 | 2007-08-05 |
| 1811100407 | Advanced Open Mri, Inc. | Clinic/Center | 605 East Main Street, Olney, IL 62450 | 2007-05-08 |
| 1548489958 | Frank Edward Gruber | Dentist | 1108 N East St, Olney, IL 62450 | 2007-04-24 |
| 1508084591 | Melvin Borja Escalona | Physical Therapist | 800 East Locust St., Olney, IL 62450 | 2007-04-23 |
| 1881769826 | Jeffrey Alan Kocher | Chiropractor | 731 S West St, Olney, IL 62450 | 2006-11-22 |
| 1336211523 | Patricia Lynn Kessler Bookhout | Dentist | 1104 North East, Olney, IL 62450 | 2006-11-14 |
| 1639159015 | Bowers Drug Store Inc | Pharmacy | 205 E Main, Olney, IL 62450 | 2006-01-20 |
| 1336137199 | South Eastern Illinois Counseling Center Inc | Counselor | 504 Micah Drive, Drawer M, Olney, IL 62450 | 2005-10-06 |
| Find all providers in zip 62450 | ||||
| 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 |
|---|---|---|---|---|
| 1043407299 | Steven M Shimoura Md Pa | Otolaryngology | 18111 Prince Philip Dr, Suite 123, Olney, MD 20832-1513 | 2007-10-02 |
| 1013049212 | Niranat Dejtiranukul | Otolaryngology | 800 E Locust St, Olney, IL 62450-2553 | 2007-03-12 |
| 1285782748 | Nicholas Mehta | Otolaryngology | 18111 Prince Philip Dr, Suite 224, Olney, MD 20832-1513 | 2007-01-08 |
| 1285681205 | Chrosniak,schwartzbauer & Mehta Md Pa | Otolaryngology | 18111 Prince Philip Dr, Suite 224, Olney, MD 20832-1513 | 2006-05-27 |
| 1457314981 | Steven Marc Shimoura | Otolaryngology | 18109 Prince Philip Dr, Suite 300, Olney, MD 20832-1519 | 2006-04-07 |
| 1346247616 | Cynthia G. Chrosniak | Otolaryngology | 18111 Prince Philip Dr, Ste 224, Olney, MD 20832-1504 | 2005-07-01 |
| 1073510343 | Heather R. Schwartzbauer | Otolaryngology | 18111 Prince Philip Dr, Ste 224, Olney, MD 20832-1504 | 2005-07-01 |
| 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.