DR. LUIS C DEVENECIA JR. (NPI# 1750495792) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750495792 |
| Entity Type | Individual |
| Full Name | DR. LUIS C DEVENECIA JR. |
| Credential | MD |
| Practice Address |
1200 N East St Weber Medical Clinic Olney IL 62450-2432 |
| Practice Telephone | 6183955222 |
| Practice Fax Number | 6183958552 |
| Mailing Telephone | 6183955222 |
| Mailing Fax Number | 6183958552 |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2012-10-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 036091236 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036091236 | 05 | |
| IL | HEALTH LINK | 296286 | 01 |
| IL | HEALTH ALLIANCE | 063073 | 01 |
| Street Address |
1200 N EAST ST WEBER MEDICAL CLINIC |
| City | OLNEY |
| State | IL |
| Zip Code | 62450-2432 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548269384 | Cecilia Howell-canada | Pediatrics | 1200 N East St, Olney, IL 62450-2432 | 2005-07-14 |
| 1578108387 | Kelcey A Semple | Pharmacist | 1200 N East St, Olney, IL 62450-2432 | 2019-11-15 |
| 1427606920 | Destiny R Dannells | Nurse Practitioner | 1200 N East St, Olney, IL 62450-2432 | 2019-08-28 |
| 1932684313 | Kylie L Garbe | Nurse Practitioner | 1200 N East St, Olney, IL 62450 | 2018-10-01 |
| 1649754474 | Amanda Dillon | Family Medicine | 1200 N East St, Olney, IL 62450-2432 | 2018-09-18 |
| 1548741960 | Stephanie Joann Greenwood | Counselor | 1200 N East St, Olney, IL 62450-2432 | 2018-08-23 |
| 1659857886 | Josette Jovero-clodfelter | Family Medicine | 1200 N East St, Olney, IL 62450-2432 | 2018-07-11 |
| 1609385269 | Coles County Mental Health Association Inc | Community/Behavioral Health | 1200 N East St, Olney, IL 62450-2432 | 2017-09-27 |
| 1609314194 | Mackenzie Zuber | Nurse Practitioner | 1200 N East St, Olney, IL 62450-2432 | 2017-02-06 |
| 1306397542 | Trenton Clapp | Physician Assistant | 1200 N East St, Olney, IL 62450-2432 | 2016-10-24 |
| 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 | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://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 |
|---|---|---|---|---|
| 1972999746 | Arooj Babar | Internal Medicine | 18101 Prince Philip Dr Ste 230n, Olney, MD 20832 | 2015-04-08 |
| 1427477363 | Rami Raouf Eltaraboulsi | Internal Medicine | 18111 Prince Philip Dr Ste 323, Olney, MD 20832-1507 | 2014-04-08 |
| 1891048336 | Marilyn Elizabeth Giles | Internal Medicine | 4100 Horatio Ct, Olney, MD 20832-2963 | 2012-10-22 |
| 1669636049 | Meron Yimen | Internal Medicine | 18101 Prince Philip Dr Ste 3060, Olney, MD 20832-1514 | 2008-07-15 |
| 1205098910 | Raza Shah | Internal Medicine | 2919 Olney Sandy Spring Rd Ste D, Olney, MD 20832 | 2008-06-25 |
| 1104013671 | Medical and Wellness Center of Olney | Internal Medicine | 4000 Olney-laytonsville Rd, Olney, MD 20832-1802 | 2007-09-28 |
| 1134321995 | Michael Elijah Murray | Internal Medicine | 4893 N Whitewater Rd, Olney, IL 62450-4325 | 2007-06-04 |
| 1437285855 | Estelle Darlyse Jean | Internal Medicine | Medstar Health Cardiology Associates, 1801 Prince Philip Drive, Suite 4100, Olney, MD 20832 | 2007-02-27 |
| 1619035573 | Alok Mathur | Internal Medicine | 4000 Olney Laytonsville Road, Olney, MD 20832 | 2006-12-04 |
| 1609967736 | Olney Medical Associates | Internal Medicine | 18109 Prince Philip Dr Ste 275, Olney, MD 20832-1576 | 2006-09-27 |
| Find all providers in OLNEY | ||||
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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.