Brandon W Divan (NPI# 1790332807, PAC ID# 5092045138) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICAL THERAPY.
| Nation Provider ID (NPI) | 1790332807 |
| PAC ID by PECOS | 5092045138 |
| Professional Enrollment ID | I20191002002904 |
| Full Name | Brandon W Divan |
| Organization Legal Name | RIVER VALLEY PHYSICAL THERAPY SPINE AND JOINT CENTER LLC |
| Address |
517 E N St Bradley IL 60915-1258 |
| Phone Number | 8158027503 |
| Gender | M |
| Graduation Year | 2019 |
| Primary Specialty | PHYSICAL THERAPY |
| Group Practice PAC ID | 8426133950 |
| Number of Group Practice Members | 4 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 517 E N St, Bradley, IL 60915-1258 | 8158027503 | RIVER VALLEY PHYSICAL THERAPY SPINE AND JOINT CENTER LLC |
| Organization Legal Name | RIVER VALLEY PHYSICAL THERAPY SPINE AND JOINT CENTER LLC |
| Physicians | 6 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jennifer L Worden | Physical Therapy | River Valley Physical Therapy Spine and Joint Center LLC | 422 S Governors Hwy, Suite 4, Peotone, IL 60468-9113 |
| Melissa G Hyma | Physical Therapy | River Valley Physical Therapy Spine and Joint Center LLC | 517 E N St, Bradley, IL 60915-1258 |
| Jenna M Bieniasz | Physical Therapy | River Valley Physical Therapy Spine and Joint Center LLC | 517 E N St, Bradley, IL 60915-1258 |
| Gerard Breuker | Physical Therapy | River Valley Physical Therapy Spine and Joint Center LLC | 517 E N St, Bradley, IL 60915-1258 |
| Katelin V Fane | Physical Therapy | River Valley Physical Therapy Spine and Joint Center LLC | 517 E N St, Bradley, IL 60915-1258 |
| Street Address |
517 E N ST |
| City | BRADLEY |
| State | IL |
| Zip | 60915-1258 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Melissa G Hyma | Physical Therapy | River Valley Physical Therapy Spine and Joint Center LLC | 517 E N St, Bradley, IL 60915-1258 |
| Jenna M Bieniasz | Physical Therapy | River Valley Physical Therapy Spine and Joint Center LLC | 517 E N St, Bradley, IL 60915-1258 |
| Gerard Breuker | Physical Therapy | River Valley Physical Therapy Spine and Joint Center LLC | 517 E N St, Bradley, IL 60915-1258 |
| Katelin V Fane | Physical Therapy | River Valley Physical Therapy Spine and Joint Center LLC | 517 E N St, Bradley, IL 60915-1258 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Elizabeth A Rieger | Clinical Social Worker | 525 E N St B, Bradley, IL 60915-1186 | |
| Beth A Shelton | Clinical Social Worker | 525 E N St B, Bradley, IL 60915-1186 | |
| J M Panuska | Preventative Medicine | Physicians Immediate Care North Chicago LLC | 350 N Kinzie Ave, Bradley, IL 60915-1221 |
| Clyde W Dayhoff Jr. | Family Medicine | Medical Group of Kankakee County | 555 E N St, Suite E, Bradley, IL 60915-1232 |
| Jennifer Carter Christenson | Physician Assistant | Medical Group of Kankakee County | 555 E N St, Suite E, Bradley, IL 60915-1232 |
| Elizabeth Barker | Nurse Practitioner | Medical Group of Kankakee County | 555 E N St, Suite E, Bradley, IL 60915-1232 |
| Kristy L Patterson | Physician Assistant | Medical Group of Kankakee County | 555 E N St, Suite E, Bradley, IL 60915-1232 |
| Hashim R Zaidi | Family Medicine | Medical Group of Kankakee County | 555 E N St, Suite E, Bradley, IL 60915-1232 |
| Jeffery D Long | Family Medicine | Medical Group of Kankakee County | 555 E N St, Suite E, Bradley, IL 60915-1232 |
| Lori R Foster | Chiropractic | 215 E N St, Bradley, IL 60915-1269 | |
| Find all physicians in zip 60915 | |||
| City | BRADLEY |
| Zip Code | 60915 |
| Specialty | PHYSICAL THERAPY |
| City + Specialty | BRADLEY + PHYSICAL THERAPY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.