NORTHERN ILLINOIS MEDICAL CENTER (NPI# 1780989905) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780989905 |
| Entity Type | Organization |
| Organization Name | NORTHERN ILLINOIS MEDICAL CENTER |
| Other Organization Name | CENTEGRA HOME MEDICAL EQUIPMENT |
| Practice Address |
213 Front St. Mchenry IL 60050-5501 |
| Practice Telephone | 8157594444 |
| Mailing Telephone | 8157594444 |
| Enumeration Date | 2011-01-19 |
| Last Update Date | 2014-03-21 |
| Authorized Official Name | DAVID TOMLINSON (CIO & CFO) |
| Authorized Official Telephone | 8157885831 |
| Is Organization Subpart | Y |
| Parent Organization Name | NORTHERN ILLINOIS MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| Other Name | Type Code |
|---|---|
| Centegra Home Medical Equipment | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770867954 | Northern Illinois Medical Center | Durable Medical Equipment & Medical Supplies | 1118 North Main Street, Algonquin, IL 60102-3482 | 2011-10-05 |
| 1447298450 | Northern Illinois Medical Center | Home Health | 213 Front St, Suite 2, Mchenry, IL 60050-5501 | 2006-06-02 |
| 1962036921 | Northern Illinois Medical Center | Clinic/Center | 3701 Doty Rd, Woodstock, IL 60098-7509 | 2020-02-28 |
| 1023497823 | Northern Illinois Medical Center | Durable Medical Equipment & Medical Supplies | 1118 N Main St, Algonquin, IL 60102-3482 | 2015-05-26 |
| 1497764526 | Northern Illinois Medical Center | Rehabilitation Unit | 4201 W Medical Center Dr, Mchenry, IL 60050-8409 | 2006-08-07 |
| 1982611281 | Northern Illinois Medical Center | Psychiatric Unit | 4201 W Medical Center Dr, Mchenry, IL 60050 | 2006-08-01 |
| Street Address |
213 FRONT ST. |
| City | MCHENRY |
| State | IL |
| Zip Code | 60050-5501 |
| 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 | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235503517 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 3900 W Elm St, Mchenry, IL 60050-4362 | 2015-11-24 |
| 1891860664 | Hanger Prosthetics & Orthotics East Inc | Durable Medical Equipment & Medical Supplies | 649 Ridgeview Dr, Mchenry, IL 60050-7012 | 2006-11-21 |
| 1285722090 | Medela, Inc. | Durable Medical Equipment & Medical Supplies | 1101 Corporate Dr, Mchenry, IL 60050-7006 | 2006-10-10 |
| 1063427201 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 3925 W Elm St, Mchenry, IL 60050-4361 | 2006-07-29 |
| 1114940467 | Gattone Pharmacy | Durable Medical Equipment & Medical Supplies | 616 S Route 31, Mchenry, IL 60050-8269 | 2006-07-26 |
| 1154343960 | Target Corporation | Durable Medical Equipment & Medical Supplies | 1860 N Richmond Rd, Mchenry, IL 60051-5416 | 2006-07-24 |
| 1457307373 | American Drug Stores LLC | Durable Medical Equipment & Medical Supplies | 4222 W Elm St Ste B, Mchenry, IL 60050 | 2006-05-25 |
| 1942665765 | Alden Terrace of Mchenry Rehab. and Health Care Center, Inc. | Durable Medical Equipment & Medical Supplies | 803 Royal Dr, Mchenry, IL 60050-4209 | 2015-12-21 |
| 1417227216 | Meijer Great Lakes Limited Partnership | Durable Medical Equipment & Medical Supplies | 2253 N Richmond Rd, Mchenry, IL 60051-5401 | 2012-01-10 |
| 1780888487 | Otto Bock Healthcare Lp | Durable Medical Equipment & Medical Supplies | 5407 Bull Valley Rd, Mchenry, IL 60050-7410 | 2007-06-14 |
| 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.