Brian B Blackmon (NPI# 1033235882, PAC ID# 6901177849) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PSYCHIATRY.
| Nation Provider ID (NPI) | 1033235882 |
| PAC ID by PECOS | 6901177849 |
| Professional Enrollment ID | I20170810001534 |
| Full Name | Brian B Blackmon |
| Organization Legal Name | CENTEGRA PRIMARY CARE LLC |
| Address |
3701 Doty Rd Woodstock IL 60098-7509 |
| Phone Number | 8153382500 |
| Gender | M |
| Graduation Year | 2013 |
| Primary Specialty | PSYCHIATRY |
| Group Practice PAC ID | 0446157630 |
| Number of Group Practice Members | 151 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 140116 | CENTEGRA HOSPITAL-MCHENRY |
| 140176 | CENTEGRA HOSPITAL - WOODSTOCK |
| Address | Phone | Organization |
|---|---|---|
| 3701 Doty Rd, Woodstock, IL 60098-7509 | 8153382500 | CENTEGRA PRIMARY CARE LLC |
| Organization Legal Name | CENTEGRA PRIMARY CARE LLC |
| Physicians | 37 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Nilam M Patel | Physician Assistant | Centegra Primary Care LLC | 11650 S Il Route 47, Huntley, IL 60142-9613 |
| Marilyn M Lacrosse | Emergency Medicine | Centegra Primary Care LLC | 360 N Terra Cotta Rd C, Crystal Lake, IL 60012-3749 |
| David A Shinherr | Chiropractic | Centegra Primary Care LLC | 11650 S Il Route 47, Huntley, IL 60142-9613 |
| Ryan Miguel Colon | Physician Assistant | Centegra Primary Care LLC | 10400 Haligus Rd, Huntley, IL 60142-9553 |
| Warren S Jablonsky | Orthopedic Surgery | Centegra Primary Care LLC | 10350 Haligus Rd, Huntley, IL 60142-9545 |
| Roseviminda Abano | Nurse Practitioner | Centegra Primary Care LLC | 4309 W Medical Ctr Dr, Mchenry, IL 60050-8419 |
| Nancy R Prokup | Nurse Practitioner | Centegra Primary Care LLC | 2507 N Richmond Rd, Mchenry, IL 60051-5407 |
| William D Cox Jr. | Sports Medicine | Centegra Primary Care LLC | 10350 Haligus Rd, Huntley, IL 60142-9545 |
| Tonya R Fisher | Nurse Practitioner | Centegra Primary Care LLC | 10350 Haligus Rd, Huntley, IL 60142-9545 |
| Ann Dilla | Family Practice | Centegra Primary Care LLC | 2507 N Richmond Rd, Mchenry, IL 60051-5407 |
| Street Address |
3701 DOTY RD |
| City | WOODSTOCK |
| State | IL |
| Zip | 60098-7509 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Alexis M Brow | Qualified Speech Language Pathologist | Independence Health and Therapy | 2028 N Seminary Ave, Woodstock, IL 60098-2626 |
| Linda Holmes Strueber | Clinical Social Worker | Independence Health and Therapy | 2028 N Seminary Ave, Woodstock, IL 60098-2626 |
| Jaclyn Kroeger | Clinical Social Worker | Independence Health and Therapy | 2028 N Seminary Ave, Woodstock, IL 60098-2626 |
| Denise J Aylesworth | Physical Therapy | Independence Health and Therapy | 2028 N Seminary Ave, Woodstock, IL 60098-2626 |
| Maurine L Kaskel | Clinical Social Worker | Family Alliance, Inc | 2028 N Seminary Ave, Woodstock, IL 60098-2626 |
| Kelly N Vinehout | Psychologist, Clinical | 645 Mchenry Ave, Woodstock, IL 60098-2922 | |
| Chris Allin | Chiropractic | 1400 N Seminary Ave, Suite K, Woodstock, IL 60098-2980 | |
| Lucinda J Hovi | Chiropractic | Hovi Clinic of Chiropractic, PC | 1400 N Seminary Ave K, Woodstock, IL 60098-2980 |
| Diane M Sunderlage | Chiropractic | 1114 N Seminary Ave, Sunderlage Chiropractic Ctr, Woodstock, IL 60098-2999 | |
| Brandi Kristen Boan | Psychologist, Clinical | Mathers Clinic LLC | 715 W Judd St, Woodstock, IL 60098-3186 |
| Find all physicians in zip 60098 | |||
| City | WOODSTOCK |
| Zip Code | 60098 |
| Specialty | PSYCHIATRY |
| City + Specialty | WOODSTOCK + PSYCHIATRY |
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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.