DR. JUAN C HERNANDEZ (NPI# 1780650176) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780650176 |
| Entity Type | Individual |
| Full Name | DR. JUAN C HERNANDEZ |
| Credential | M.D. |
| Practice Address |
102 S Hennepin Ave Dixon IL 61021 |
| Mailing Address |
102 S. Hennepin Ave. Dixon IL 61021 |
| Practice Telephone | 8152887711 |
| Practice Fax Number | 8152858922 |
| Mailing Telephone | 8152887711 |
| Mailing Fax Number | 8152858922 |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2018-08-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | 036-112949 | IL | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | 036-112949 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | MEDICARE-KATHERINE SHAW BETHEA HOSPITAL | 800200003 | 01 |
| IL | 036112949 | 05 | |
| IL | MEDICARE-KSB MEDICAL GROUP | K16904 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 403 E 1st St, Dixon, IL 610213116 | 8152855552 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174000194 | Juan Duenes Hernandez | Behavioral Analyst | 424 Noice Dr Apt 88e, Salinas, CA 93906-2870 | 2018-07-23 |
| 1336668466 | Juan Hernandez | Chiropractor | 13950 Foothill Blvd Apt 108, Sylmar, CA 91342 | 2017-09-09 |
| 1831599935 | Juan Hernandez | Contractor | 9182 Nw 114th St, Hialeah Gardens, FL 33018-4137 | 2014-08-26 |
| 1730425323 | Juan E Hernandez | General Practice | Carr #2 (marginal) Km 119.2, Bo Caimital Alto, Aguadilla, PR 00603 | 2012-12-31 |
| 1457657157 | Juan Pablo Hernandez | Counselor | 3465 Mcnutt Rd, Sunland Park, NM 88063-9056 | 2011-01-28 |
| 1427361302 | Juan Francisco Hernandez | Nurse Practitioner | 1914 Orange Blossom Dr, Laredo, TX 78045-8355 | 2010-07-20 |
| 1154640001 | Juan Antonio Hernandez | Internal Medicine | 232 N John Redditt Dr Ste B, Lufkin, TX 75904-2620 | 2010-05-18 |
| 1356542070 | Juan Francisco Hernandez | Preventive Medicine | Carr.2,km. 98.7,bo Cocos, Quebradillas, PR 00678 | 2007-05-30 |
| 1700943990 | Juan Ramon Hernandez | Otolaryngology | 27 Nettleton Dr, Woodbridge, CT 06525 | 2007-01-03 |
| 1922183409 | Juan Hernandez | Counselor | 310 E Van Buren Ave, Suite 123, Harlingen, TX 78550-6815 | 2006-10-25 |
| Street Address |
102 S HENNEPIN AVE |
| City | DIXON |
| State | IL |
| Zip Code | 61021 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023626751 | Kirk Anthony Stewart | Family Medicine | 102 S Hennepin Ave, Dixon, IL 61021-3013 | 2020-07-20 |
| 1396363727 | Kristina A Stevenson | Family Medicine | 102 S Hennepin Ave, Dixon, IL 61021-3013 | 2020-07-13 |
| 1801425277 | Sinnissippi Centers, Inc. | Clinic/Center | 102 S Hennepin Ave, Dixon, IL 61021-3013 | 2020-04-07 |
| 1235768607 | Sinnissippi Centers, Inc. | Clinic/Center | 102 S Hennepin Ave, Dixon, IL 61021-3013 | 2020-04-07 |
| 1609413632 | Gina Aikins | Dietitian, Registered | 102 S Hennepin Ave, Dixon, IL 61021-3013 | 2019-12-10 |
| 1417518531 | Tyler J Verbout | Counselor | 102 S Hennepin Ave, Dixon, IL 61021 | 2019-06-28 |
| 1356901482 | Justin Levon Du | Family Medicine | 102 S Hennepin Ave, Dixon, IL 61021-3013 | 2019-06-20 |
| 1184283590 | Jaclyn Pranita Parayao | Family Medicine | 102 S Hennepin Ave, Dixon, IL 61021-3013 | 2019-06-10 |
| 1427542067 | Michael Greer | Family Medicine | 102 S Hennepin Ave, Dixon, IL 61021-3013 | 2018-06-18 |
| 1942792726 | Paige Breanne Clayton | Family Medicine | 102 S Hennepin Ave, Dixon, IL 61021-3013 | 2018-06-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699331082 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1600 South Galena Ave, Dixon, IL 61021 | 2019-05-12 |
| 1285135590 | Richard Allen Sibert | Counselor | 325 Il Route 2,dixon Il, Dixon, IL 61021 | 2018-02-22 |
| 1518485432 | Madeline Luniewicz | Counselor | 325 Il-2, Dixon, IL 61021 | 2017-08-30 |
| 1669992566 | Nicole Marie Shaffer | Specialist/Technologist | 650 Reynoldswood Road, Dixon, IL 61021 | 2017-06-21 |
| 1346660446 | Lydia Sitter | Audiologist | 215 3. 1st Street, Suite 317, Ksb Medical Group, Dixon, IL 61021 | 2014-04-16 |
| 1053600080 | Janet I. Malmberg | Nurse Practitioner | 309 South Galena Ave, Suite 100, Dixon, IL 61021 | 2011-03-30 |
| 1376775262 | Kelly L Klein | Optometrist | 511 Palmyra Street, Ksb Eye & Vision Care, Dixon, IL 61021 | 2009-08-11 |
| 1013119106 | Michael Joseph Sarno | Physical Therapist | 401 E. First Street, Dixon, IL 61021 | 2007-06-01 |
| 1891905600 | Thomas G. Gehlbach | Internal Medicine | 215 E 1st St Ste 111, Dixon, IL 61021 | 2007-05-23 |
| 1699987230 | Sameer Jain | Family Medicine | 102 S. Hennepin Ave., Ksb Medical Group, Dixon, IL 61021 | 2007-05-04 |
| Find all providers in zip 61021 | ||||
| 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 |
|---|---|---|---|---|
| 1205091139 | William Edward Colyer | Family Medicine | Hwy 28 100 E. 5th Street, Dixon, MO 65459 | 2008-07-21 |
| 1033381439 | Rajender Singh Dahiya | Family Medicine | 1700 S Galena Ave, Dixon, IL 61021-9695 | 2008-03-26 |
| 1699987230 | Sameer Jain | Family Medicine | 102 S. Hennepin Ave., Ksb Medical Group, Dixon, IL 61021 | 2007-05-04 |
| 1659467215 | Sandra D Lee | Family Medicine | 125 North Lincoln, #g, Dixon, CA 95620 | 2006-10-04 |
| 1417937632 | Alpheus T Appenheimer | Family Medicine | Ksb Medical Group, 102 S Hennepin Ave, Dixon, IL 61021 | 2006-01-23 |
| 1235135682 | Dixon Family Practice and Internal Medicine, LLC | Family Medicine | 206 West 2nd Street, Dixon, MO 65459-0940 | 2005-06-21 |
| 1023626751 | Kirk Anthony Stewart | Family Medicine | 102 S Hennepin Ave, Dixon, IL 61021-3013 | 2020-07-20 |
| 1396363727 | Kristina A Stevenson | Family Medicine | 102 S Hennepin Ave, Dixon, IL 61021-3013 | 2020-07-13 |
| 1356901482 | Justin Levon Du | Family Medicine | 102 S Hennepin Ave, Dixon, IL 61021-3013 | 2019-06-20 |
| 1184283590 | Jaclyn Pranita Parayao | Family Medicine | 102 S Hennepin Ave, Dixon, IL 61021-3013 | 2019-06-10 |
| Find all providers in DIXON | ||||
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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.