PREMIER SUBURBAN MEDICAL GROUP, PLLC (NPI# 1902412950) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902412950 |
| Entity Type | Organization |
| Organization Name | PREMIER SUBURBAN MEDICAL GROUP, PLLC |
| Practice Address |
1900 Silver Cross Blvd New Lenox IL 60451-9509 |
| Practice Telephone | 8153007106 |
| Enumeration Date | 2020-09-16 |
| Last Update Date | 2020-11-05 |
| Authorized Official Name | AMY OWENS (DIRECTOR, FINANCE) |
| Authorized Official Telephone | 8153007764 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| Street Address |
1900 SILVER CROSS BLVD |
| City | NEW LENOX |
| State | IL |
| Zip Code | 60451-9509 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407828882 | Nisha Patel | Radiology | 1900 Silver Cross Blvd, New Lenox, IL 60451-9509 | 2006-02-01 |
| 1902425937 | Sara Doornbosch | Nurse Practitioner | 1900 Silver Cross Blvd, New Lenox, IL 60451-9509 | 2020-04-09 |
| 1962038968 | Hollie Ann Nieland | Nurse Practitioner | 1900 Silver Cross Blvd, New Lenox, IL 60451-9509 | 2020-03-21 |
| 1851926869 | Health Services Systems, Inc | Internal Medicine | 1900 Silver Cross Blvd, New Lenox, IL 60451-9509 | 2020-03-10 |
| 1376177220 | Taylor Baldermann | Nurse Practitioner | 1900 Silver Cross Blvd, New Lenox, IL 60451 | 2020-03-01 |
| 1114559044 | Sara Milano | Nurse Practitioner | 1900 Silver Cross Blvd, New Lenox, IL 60451-9509 | 2020-02-08 |
| 1003459199 | Connie Lynn Machetta | Dietitian, Registered | 1900 Silver Cross Blvd, New Lenox, IL 60451-9509 | 2019-10-22 |
| 1972144715 | Rebecca Mireles | Nurse Practitioner | 1900 Silver Cross Blvd, New Lenox, IL 60451-9509 | 2019-10-02 |
| 1124596408 | Cammie C Liu | Physician Assistant | 1900 Silver Cross Blvd, New Lenox, IL 60451-9509 | 2018-11-05 |
| 1861991069 | Kristina Lendabarker | Nurse Anesthetist, Certified Registered | 1900 Silver Cross Blvd, New Lenox, IL 60451-9509 | 2018-02-03 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871126227 | Forever Family Dental of New Lenox | Dentist | 202 Vancina Lane, New Lenox, IL 60451 | 2020-02-13 |
| 1699245662 | Highland Park Cvs LLC | Durable Medical Equipment & Medical Supplies | 115 East Maple St, New Lenox, IL 60451 | 2018-12-03 |
| 1093204778 | New Lenox Anesthesia LLC | Anesthesiology | 678 Cedar Crossing Dr, New Lenox, IL 60451 | 2018-05-08 |
| 1578068698 | My Medicar | Non-emergency Medical Transport (VAN) | 21625 S. Schoolhouse Rd, New Lenox, IL 60451 | 2018-03-29 |
| 1134646771 | Julianne M. Goudzwaard | Registered Nurse | 841 Buckboard Drive, New Lenox, IL 60451 | 2017-08-24 |
| 1063947422 | Silver Cross Ambulatory Surgery Center, LLC | Clinic/Center | 1003 Pawlak Parkway, New Lenox, IL 60451 | 2017-04-24 |
| 1386090041 | Lindsey Reimer | Speech-Language Pathologist | 3515 Golf Ave, New Lenox, IL 60451 | 2016-05-11 |
| 1295105484 | Alison Elaine Burchardt | Nurse Practitioner | 1890 Silver Cross Boulevard, Pavilion A, Suite 240, New Lenox, IL 60451 | 2015-09-30 |
| 1700278959 | Dental Professionals of Illinois, P.c | Dentist | 561 E Lincoln Hwy, New Lenox, IL 60451 | 2015-02-25 |
| 1912319146 | Teresea Bargewell | Counselor | 1049 E. Lincoln Hwy, Decision Point Counseling and Career Center, New Lenox, IL 60451 | 2014-05-22 |
| Find all providers in zip 60451 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467860833 | Meridian App Medical Services, LLC | Clinic/Center | 1870 Silver Cross Blvd, Suite 240, New Lenox, IL 60451-8639 | 2014-07-29 |
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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.