OB PRACTICE, LLC (NPI# 1770946204) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770946204 |
| Entity Type | Organization |
| Organization Name | OB PRACTICE, LLC |
| Practice Address |
1404 Cross St Third Floor Suite 3181 Shiloh IL 62269-2988 |
| Mailing Address |
4500 Memorial Drive Memorial Hospital Medical Affairs Credentialing Dept Belleville IL 62226 |
| Practice Telephone | 6182574644 |
| Mailing Telephone | 6182574644 |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2016-04-28 |
| Authorized Official Name | JAMES B DAVIS (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6182574644 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
Allopathic & Osteopathic Physicians | ||
| N | 207VX0000X |
Obstetrics & Gynecology Specialization: Obstetrics |
Allopathic & Osteopathic Physicians | ||
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437672771 | Ob Practice, LLC | Obstetrics & Gynecology | 1414 Cross St Ste 240, Shiloh, IL 62269-2988 | 2017-07-19 |
| 1629386586 | Ob Practice, LLC | Obstetrics & Gynecology | 4600 Memorial Drive, Ste. 400, Belleville, IL 62226 | 2010-09-14 |
| Street Address |
1404 CROSS ST THIRD FLOOR SUITE 3181 |
| City | SHILOH |
| State | IL |
| Zip Code | 62269-2988 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801023155 | Wendy Maclean | Emergency Medicine | 1404 Cross St, Shiloh, IL 62269 | 2009-06-14 |
| 1902389711 | Cynthia Ann Davis | Registered Nurse | 1404 Cross St, Shiloh, IL 62269-2988 | 2018-09-08 |
| 1942712476 | Cep America - Illinois Snf, LLP | Internal Medicine | 1404 Cross St, Shiloh, IL 62269-2988 | 2017-10-24 |
| 1760939060 | Msa Alliance, LLC | Internal Medicine | 1404 Cross St, Suite 2114, Shiloh, IL 62269-2988 | 2016-09-02 |
| 1619327376 | Ca Group, LLC | Internal Medicine | 1404 Cross St, Suite 2940, Shiloh, IL 62269-2988 | 2016-06-14 |
| 1477917656 | Oa Associates, LLC | Orthopaedic Surgery | 1404 Cross St, 2nd Floor Suite 2941, Shiloh, IL 62269-2988 | 2016-04-13 |
| 1578921557 | Cep Americia-illinois Intensivists | Internal Medicine | 1404 Cross St, Shiloh, IL 62269-2988 | 2016-02-04 |
| 1619335106 | Cep America-illinois Hospitalists, LLP | Family Medicine | 1404 Cross St, Shiloh, IL 62269-2988 | 2016-01-29 |
| 1134587637 | Cep America Illinois LLP | Emergency Medicine | 1404 Cross St, Shiloh, IL 62269-2988 | 2016-01-29 |
| 1699146431 | Linsey Krafve | Physician Assistant | 1404 Cross St, Shiloh, IL 62269-2988 | 2015-10-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326648155 | Kayla Revermann | Pharmacist | 1350 W Us Highway 50, Pharmacy, O Fallon, IL 62269 | 2020-10-30 |
| 1942814272 | Ashley Monique Gibson | Behavior Technician | Eagle Center, Ste 10, Ofallon, IL 62269 | 2020-09-03 |
| 1013533819 | Michelle Denise Voudrie | Registered Nurse | 321 Regency Park, O'fallon, IL 62269 | 2020-06-18 |
| 1598398455 | Washington University Physicians In Illinois - Cancer Center Pharmacy | Pharmacy | 1418 Cross Street, Suite 180, Shiloh, IL 62269 | 2020-02-19 |
| 1962063800 | Gerald Paskert | Pharmacist | 122 W. State St., O'fallon, IL 62269 | 2019-06-21 |
| 1780144808 | Bonnie Jean Lampe | Physical Therapy Assistant | 316 Donna Dr, O'fallon, IL 62269 | 2019-03-24 |
| 1134633993 | Latisha Smith | Psychologist | 600 S. Smiley St., O'fallon, IL 62269 | 2017-11-30 |
| 1619407210 | Brenna M Thomas | Registered Nurse | 1310 Engle Ct, O'fallon, IL 62269 | 2017-06-15 |
| 1881135622 | Pc Associates, LLC | Family Medicine | 800 East Highway 50, O'fallon, IL 62269 | 2017-03-13 |
| 1700230539 | Jennifer Farrell | Family Medicine | 3 St. Elizabeth's Blvd, Ste. 4000, O'fallon, IL 62269 | 2016-04-18 |
| Find all providers in zip 62269 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| 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 Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437672771 | Ob Practice, LLC | Obstetrics & Gynecology | 1414 Cross St Ste 240, Shiloh, IL 62269-2988 | 2017-07-19 |
| 1598150393 | Andrew Mayo | Obstetrics & Gynecology | 1197 Fortune Blvd Ste 1, Shiloh, IL 62269-7377 | 2015-03-30 |
| 1700270816 | Kristen Kapalka Griffin | Obstetrics & Gynecology | 1170 Fortune Blvd, Shiloh, IL 62269 | 2015-03-26 |
| 1689990863 | Elizabeth Anne George | Obstetrics & Gynecology | 1197 Fortune Blvd, Suite 1, Shiloh, IL 62269-7377 | 2010-04-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578162210 | Clair L Casagrande | Obstetrics & Gynecology | 1300 Franklin Ave Ste 330, Normal, IL 61761-4204 | 2020-10-23 |
| 1699382531 | Contemporary Ob/gyn Chicago, Pllc | Obstetrics & Gynecology | 2007 S State St, Chicago, IL 60616-2173 | 2020-09-24 |
| 1831711381 | Baillie Anne Bronner | Obstetrics & Gynecology | 1653 W Congress Pkwy Chicago, Il 60612, Chicago, IL 60612 | 2020-05-07 |
| 1851910210 | Wayne Richard Burrows | Obstetrics & Gynecology | 1412 S Diamond St, South Jacksonville, IL 62650-3143 | 2020-04-15 |
| 1285272807 | Jersey Community Hospital | Obstetrics & Gynecology | #2 Memorial Drive, Suite 203, Alton, IL 62002 | 2019-12-13 |
| 1962050971 | Jessica Erin Buesing | Obstetrics & Gynecology | 27790 W Highway 22 Ste 37, Barrington, IL 60010-2396 | 2019-09-03 |
| 1235784760 | Gynecologic Surgery & Menopause Solutions PC | Obstetrics & Gynecology | 1890 Silver Cross Blvd Ste 445, New Lenox, IL 60451-9622 | 2019-08-01 |
| 1477105187 | Anthony Greis | Obstetrics & Gynecology | 540 Lake Cook Road, Suite 300, Deerfield, IL 60015 | 2019-07-12 |
| 1164980769 | Hanna Legator | Obstetrics & Gynecology | 1875 Dempster St Ste 300, Park Ridge, IL 60068-1186 | 2019-03-04 |
| 1255828448 | Vera W Brink | Obstetrics & Gynecology | Parkside Professional Center, 1875 Dempster St., Ste. 330, Park Ridge, IL 60068 | 2018-04-13 |
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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.