DR. BRIAN BENJAMIN BLACKMON (NPI# 1033235882) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033235882 |
| Entity Type | Individual |
| Full Name | DR. BRIAN BENJAMIN BLACKMON |
| Credential | DO |
| Practice Address |
3701 Doty Rd Woodstock IL 60098 |
| Mailing Address |
3701 Doty Rd Woodstock IL 60098-7509 |
| Practice Telephone | 8153386600 |
| Practice Fax Number | 8152065376 |
| Mailing Telephone | 8153386600 |
| Mailing Fax Number | 8152065376 |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2018-12-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
036142922 | IL | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | STATE LICENSE | 036142922 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2301 Erwin Rd, Durham, NC 277104699 | 9196848111 | |
| 10400 Haligus Rd, Huntley, IL 601429553 | 8153386600 | 8152065376 |
| 4201 W Medical Center Dr, Mchenry, IL 600508409 | 8153386600 | 8152065376 |
| 10350 Haligus Rd Ste 200, Huntley, IL 601429545 | 8153386600 | |
| 527 W South St, Woodstock, IL 600983756 | 8153386600 | 8152065376 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821633660 | Brian Carl Blackmon | Physical Medicine & Rehabilitation | 1000 Us Highway 82 E, Sherman, TX 75090-1704 | 2019-11-15 |
| Street Address |
3701 DOTY RD |
| City | WOODSTOCK |
| State | IL |
| Zip Code | 60098 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891794681 | Thomas Peeters | Emergency Medicine | 3701 Doty Rd, Woodstock, IL 60098-7509 | 2005-07-14 |
| 1962036921 | Northern Illinois Medical Center | Clinic/Center | 3701 Doty Rd, Woodstock, IL 60098-7509 | 2020-02-28 |
| 1568024982 | Kyle Joseph Saunders | Counselor | 3701 Doty Rd, Woodstock, IL 60098-7509 | 2019-07-05 |
| 1962990309 | Ravi Khapekar | Nurse Anesthetist, Certified Registered | 3701 Doty Rd, Woodstock, IL 60098-7509 | 2018-05-01 |
| 1982137337 | Maria Prusha | Pharmacist | 3701 Doty Rd, Woodstock, IL 60098-7509 | 2017-04-04 |
| 1699220525 | Grazyna Kostecki | Pharmacist | 3701 Doty Rd, Woodstock, IL 60098-7509 | 2016-08-21 |
| 1164871836 | Megan Garcia | Behavioral Analyst | 3701 Doty Rd, Woodstock, IL 60098-7509 | 2016-06-03 |
| 1164876967 | Nicholas K Ventocilla | Nurse Anesthetist, Certified Registered | 3701 Doty Rd, Woodstock, IL 60098-7509 | 2016-04-18 |
| 1225498660 | Kimberly Anne Saathoff | Pharmacist | 3701 Doty Rd, Woodstock, IL 60098-7509 | 2016-02-27 |
| 1124486790 | Angela K Astleford | Nurse Practitioner | 3701 Doty Rd, Woodstock, IL 60098 | 2016-02-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083197453 | Abb Dental Group LLC | Dentist | 11585 Us 14, Woodstock, IL 60098 | 2018-09-12 |
| 1396256467 | Gezelle Adams | Social Worker | 1200 Walden Oaks Dr, Woodstock, IL 60098 | 2017-10-17 |
| 1861910721 | Letitia Susan Edgell | Technician | 503 Lawndale Ave., Woodstock, IL 60098 | 2017-08-31 |
| 1104355460 | Jessica Evertsen | Doula | 435 Laurel Ave, Woodstock, IL 60098 | 2017-06-08 |
| 1871026724 | Bo Yeon Bartilotta | Dentist | 11585 Us-14, Woodstock, IL 60098 | 2017-04-07 |
| 1619337185 | Julia Karibian | Community Health Worker | 2983 Strauss Court, Woodstock, IL 60098 | 2016-02-26 |
| 1407249170 | Julia Bonti | Counselor | 13318 Hickory Ln, Woodstock, IL 60098 | 2015-03-05 |
| 1427485580 | Sara E Smedinghoff | Physical Therapy Assistant | 708 Washington Street, Woodstock, IL 60098 | 2013-10-03 |
| 1669721783 | Robert Eugene Haraden | Dentist | 651 S. Eastwood Dr, Woodstock, IL 60098 | 2012-09-05 |
| 1831447440 | Carla Peltier | Social Worker | 101 South Jefferson Street, Woodstock, IL 60098 | 2012-08-29 |
| Find all providers in zip 60098 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871843839 | Alexander J. Mercer, M.d., LLC | Psychiatry & Neurology | 418 Creekstone Ridge, Woodstock, GA 30188-3740 | 2012-09-17 |
| 1477816445 | Aroon Suansilppongse | Psychiatry & Neurology | 1 Deep Powder Ct, Woodstock, MD 21163-1110 | 2012-06-24 |
| 1003046046 | Dennis R Brightwell, Md, Sc | Psychiatry & Neurology | 310 N Rose Farm Rd, Woodstock, IL 60098-9540 | 2009-07-24 |
| 1821153511 | Alexander John Mercer | Psychiatry & Neurology | 418 Creekstone Rdg, Woodstock, GA 30188-3740 | 2006-12-24 |
| 1740371715 | Shelley Sellinger | Psychiatry & Neurology | 22 Lark Dr, Woodstock, NY 12498-1427 | 2006-09-27 |
| 1497198832 | Gabriel C Fuqua | Psychiatry & Neurology | 3701 Doty Rd, Woodstock, IL 60098 | 2013-04-16 |
| 1114078193 | David D. Brunette | Psychiatry & Neurology | 8910 Main St, Woodstock, GA 30188-4916 | 2007-01-16 |
| 1841394566 | Shenandoah Memorial Hospital | Psychiatry & Neurology | 759 S Main St, Woodstock, VA 22664-1127 | 2006-09-12 |
| 1306883178 | Thomas M Cardwell | Psychiatry & Neurology | 759 S Main St, Woodstock, VA 22664-1127 | 2006-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346840659 | Amelia Mari Merz | Psychiatry & Neurology | 1101 Lake St Ste 201b, Oak Park, IL 60301-1046 | 2020-10-27 |
| 1063024925 | Mindful Psychiatric Care LLC | Psychiatry & Neurology | 120 E Ogden Ave Ste 101, Hinsdale, IL 60521-3892 | 2020-08-20 |
| 1053921296 | Healing Hands Resource Center | Psychiatry & Neurology | 6607 W Main St, Belleville, IL 62223-3025 | 2020-08-03 |
| 1144848086 | Zachary A Kordik Md PC | Psychiatry & Neurology | 25 E Washington St Ste 904, Chicago, IL 60602-1715 | 2020-07-07 |
| 1629694278 | Montes Psychiatric Center, P.C. | Psychiatry & Neurology | 717 Trent Ln, Loves Park, IL 61111-8956 | 2020-06-19 |
| 1659996767 | Bluesky Telepsych | Psychiatry & Neurology | 4753 N Broadway St Ste 910, Chicago, IL 60640-4991 | 2020-06-15 |
| 1164047833 | Advanced Psychiatry Clinics, S.c. | Psychiatry & Neurology | 5519 N Cumberland Ave Ste 1016, Chicago, IL 60656-1480 | 2020-06-09 |
| 1326661802 | Psychmed Clinic Inc | Psychiatry & Neurology | 2159 W Madison St, Chicago, IL 60612-2307 | 2020-05-19 |
| 1467074534 | Holmes Psychiatry LLC | Psychiatry & Neurology | 2027 W Division St # 144, Chicago, IL 60622-9024 | 2020-05-12 |
| 1902434947 | Saadiya Jabbar | Psychiatry & Neurology | Loyola University Medical Center, Building 105, Suite 1940, Maywood, IL 60153 | 2020-03-27 |
| Find all providers with the same taxonomy | ||||
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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.