ANDREA SUE CLEM (NPI# 1770541369) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770541369 |
| Entity Type | Individual |
| Full Name | ANDREA SUE CLEM |
| Credential | DO |
| Practice Address |
5404 W Elm St Suite Q Mchenry IL 60050-4052 |
| Practice Telephone | 8153440020 |
| Practice Fax Number | 8153440076 |
| Mailing Telephone | 8153440020 |
| Mailing Fax Number | 8153440076 |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2010-07-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 036123085 | IL | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 34007131C | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2184372 | 05 | |
| ANTHEM | 000000201819 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386939874 | Andrea Clem | Pharmacist | 720 S.w. 19th St., T-2727, Moore, OK 73160 | 2011-06-13 |
| Street Address |
5404 W ELM ST SUITE Q |
| City | MCHENRY |
| State | IL |
| Zip Code | 60050-4052 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598321622 | Jaimie V Senese | Counselor | 5404 W Elm St, Mchenry, IL 60050-4052 | 2019-05-14 |
| 1114492303 | Carly Wolfram | Psychologist | 5404 W Elm St, Mchenry, IL 60050-4052 | 2018-10-04 |
| 1720252224 | Charles J Tannenbaum | Dentist | 5404 W Elm St, Ste F, Mchenry, IL 60050-4052 | 2008-04-15 |
| 1245304450 | Procare Dental Group, P.C. | Dentist | 5404 W Elm St, Ste F, Mchenry, IL 60050-4052 | 2006-11-20 |
| 1497860951 | Jeanne Marie Browning | Registered Nurse | 5404 W Elm St, Suite Q, Mchenry, IL 60050-4052 | 2006-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932728003 | Tco Jv, LLC | Skilled Nursing Facility | 550 Ridgeview Drive, Mchenry, IL 60050 | 2020-04-09 |
| 1992274971 | Lisa Luedtke | Counselor | 5342 West Elm Street, Mchenry, IL 60050 | 2018-11-19 |
| 1013402825 | Fox Ridge Medical Associates, LLC | Internal Medicine | 3633 Municipal Dr, Mchenry, IL 60050 | 2018-06-25 |
| 1700387065 | Richard Stacy Birmantas | Speech-Language Pathologist | 6515 West Route 120, Mchenry, IL 60050 | 2018-02-22 |
| 1659888774 | Kathleen Mather | Speech-Language Pathologist | 3502 Washington St, Mchenry, IL 60050 | 2018-01-10 |
| 1891205605 | Delorean Mckinney | Psychologist | 4031 Dayton Ave, Mchenry, IL 60050 | 2017-10-06 |
| 1851810741 | Diana Park | Pharmacist | 2253 N. Richmond Rd., Mchenry, IL 60050 | 2017-09-12 |
| 1063931921 | Lauren M Young | Counselor | 4031 W. Dayton Street, Mchenery, IL 60050 | 2017-09-12 |
| 1376086264 | Elizabeth Kathleen Zacher | Social Worker | 4100 W Dayton Street, Mchenry, IL 60050 | 2016-11-23 |
| 1700332491 | Jasmine Elias | Social Worker | 4031 Dayton St, Mchenry, IL 60050 | 2016-09-01 |
| Find all providers in zip 60050 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699860635 | John Edward Albanese | Family Medicine | 4302 W Crystal Lake Rd Ste A, Mchenry, IL 60050-4248 | 2006-10-04 |
| 1588760458 | Clinical Practice Management, P.C. | Family Medicine | 4805 W. Prime Parkway, Mchenry, IL 60051 | 2006-09-16 |
| 1164426094 | Oscar Mauricio Sanchez | Family Medicine | 5435 Bull Valley Rd, Ste 218, Mchenry, IL 60050-7435 | 2005-06-09 |
| 1194270926 | Gypsum Medical Associates of California PC | Family Medicine | 4805 Prime Pkwy, Mchenry, IL 60050-7002 | 2016-08-22 |
| 1861836033 | George Nithin Thomas | Family Medicine | 4309 W Medical Center Dr Ste A102, Mchenry, IL 60050-8436 | 2013-04-18 |
| 1568723211 | Pradeep N Raju | Family Medicine | 4119 W Shamrock Ln, Mchenry, IL 60050-8268 | 2012-05-30 |
| 1508093527 | Uwa Kalu | Family Medicine | 4309 W Medical Center Dr Ste A102, Mchenry, IL 60050-8436 | 2009-06-17 |
| 1740494236 | Sindhu V Perumal | Family Medicine | 4309 W Medical Center Dr Ste B300, Mchenry, IL 60050 | 2007-05-10 |
| 1063637544 | Syed Ommar Hassan | Family Medicine | 3922 Mercy Dr, Mchenry, IL 60050-3179 | 2007-04-17 |
| 1316094030 | Maria F Vlahos | Family Medicine | 3922 Mercy Dr, Mchenry, IL 60050-3151 | 2007-01-04 |
| Find all providers in MCHENRY | ||||
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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.