ELLIE MARIE BENTLEY (NPI# 1093157315) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093157315 |
| Entity Type | Individual |
| Full Name | ELLIE MARIE BENTLEY |
| Credential | D.O. |
| Practice Address |
220 S Park Ave Fl 3 Herrin IL 62948 |
| Mailing Address |
Po Box 3988 Carbondale IL 62902-3988 |
| Practice Telephone | 6189422002 |
| Practice Fax Number | 6183516497 |
| Mailing Telephone | 6184575200 |
| Mailing Fax Number | 6185290586 |
| Enumeration Date | 2013-07-28 |
| Last Update Date | 2019-08-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 036150570 | IL | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1 Medical Center Dr, Suite 162, Stratford, NJ 080841500 | 8565666708 |
| Street Address |
220 S PARK AVE FL 3 |
| City | HERRIN |
| State | IL |
| Zip Code | 62948 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659599538 | Brett Michael Dempsey | Surgery | 220 S Park Ave Fl 3, Herrin, IL 62948-3602 | 2007-04-23 |
| 1609286509 | Benjamin P Roose | Surgery | 220 S Park Ave Fl 3, Herrin, IL 62948 | 2014-04-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215307590 | Carmelito Miralles Caronongan | Pediatrics | 120 S. 11th St., Herrin, IL 62948 | 2015-09-30 |
| 1073995684 | Motaz R Wraikat | Preventive Medicine | 315 S 13th St Ste 3, Herrin, IL 62948 | 2015-06-19 |
| 1639427933 | Salim Hosein | Surgery | 317 S 14th St Ste 1, Herrin, IL 62948 | 2012-08-17 |
| 1962780288 | Pooja Sareen | Internal Medicine | 3024 S Park Avenue, Herrin, IL 62948 | 2011-08-03 |
| 1235459918 | Timoteo Castro Md & Josefina D. Castro Md Ltd | Family Medicine | 321 South 13st St., Herrin, IL 62948 | 2010-06-04 |
| 1457501926 | Don Cassidy Arnold II | Urology | 220 S Park Ave Fl 2, Herrin, IL 62948 | 2008-09-22 |
| 1306094560 | Karl Keith Mitchener | Speech-Language Pathologist | 1901 N 13th Street, Herrin, IL 62948 | 2008-08-29 |
| 1457509705 | Kathryn Marie Bordenet-jines | Occupational Therapy Assistant | 1901 N. 13th, Herrin, IL 62948 | 2008-08-28 |
| 1417105776 | Cheryl Lynn Matic | Occupational Therapy Assistant | 1901 N. 13th St., Herrin, IL 62948 | 2008-08-28 |
| 1174771422 | Mary Frances Graham | Physical Therapy Assistant | 1901 N. 13th Street, Herrin, IL 62948 | 2008-08-28 |
| Find all providers in zip 62948 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639427933 | Salim Hosein | Surgery | 317 S 14th St Ste 1, Herrin, IL 62948 | 2012-08-17 |
| 1659599538 | Brett Michael Dempsey | Surgery | 220 S Park Ave Fl 3, Herrin, IL 62948-3602 | 2007-04-23 |
| 1548344997 | Watanachai Sujatanond | Surgery | 201 South 14th Street, Herrin, IL 62948 | 2006-10-24 |
| 1083728000 | William F. Hays | Surgery | 3305 Logan Dr, Herrin, IL 62948-3732 | 2006-08-18 |
| 1366452443 | Medha Suwanawongse | Surgery | 121 N 13th St, Herrin, IL 62948-3248 | 2006-08-09 |
| 1548205222 | Antoni J Kos | Surgery | 3307 Logan Dr Ste B, Herrin, IL 62948-3732 | 2006-06-18 |
| 1457355315 | Robert Judson Brewer | Surgery | 220 S Park Ave, 3rd Floor, Herrin, IL 62948-3612 | 2005-06-09 |
| 1609286509 | Benjamin P Roose | Surgery | 220 S Park Ave Fl 3, Herrin, IL 62948 | 2014-04-30 |
| 1538591268 | Amar Rawal | Surgery | 220 S Park Ave Fl 2, Herrin, IL 62948 | 2013-08-05 |
| 1457664047 | Saad Ajmal | Surgery | 317 S 14th St, Suite 1, Herrin, IL 62948-3671 | 2010-07-23 |
| Find all providers in HERRIN | ||||
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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.