MS. JULIE PROMBO (NPI# 1114441011) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114441011 |
| Entity Type | Individual |
| Full Name | MS. JULIE PROMBO |
| Credential | PA-C |
| Practice Address |
420 E Il Route 173 Ste 101 Antioch IL 60002-7284 |
| Practice Telephone | 8476529700 |
| Mailing Telephone | 8476529700 |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2019-10-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
085006255 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
420 E IL ROUTE 173 STE 101 |
| City | ANTIOCH |
| State | IL |
| Zip Code | 60002-7284 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265090849 | Lake County Immediate Care, LLC | Clinic/Center | 420 E Il Route 173 Ste 101, Antioch, IL 60002-7284 | 2019-05-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821620345 | Kathleen Ann Bleyaert | Technician | 24238 W. Bayview Rd, Antioch, IL 60002 | 2020-02-12 |
| 1992354385 | Pauravi Hefner | Developmental Therapist | 270 Hickory Lane, Antioch, IL 60002 | 2019-09-09 |
| 1689023558 | Shannon Marie Herman | Pharmacist | 966 Route 59, Antioch, IL 60002 | 2016-06-10 |
| 1992151856 | Suchitra Gosavi | Physical Therapist | 3703west Lake Ave, Suit 200, Glenview, IL 60002 | 2016-05-10 |
| 1336513357 | Athletico Ltd | Physical Therapist | 1122 Main St., Antioch, IL 60002 | 2015-11-16 |
| 1811306335 | Jennifer Fitzgerald | Massage Therapist | 673 Cameron Drive, Antioch, IL 60002 | 2014-08-08 |
| 1114262052 | Michael W Silenzi | Physical Therapist | 543 Orchard Str, Antioch, IL 60002 | 2012-12-04 |
| 1659561678 | Expert Home Medical Equipment LLC | Durable Medical Equipment & Medical Supplies | 40225 N Rt 83, Suite B, Antioch, IL 60002 | 2007-07-26 |
| 1821157769 | Robert T Sven,dds,ltd | Dentist | 439 Lake Street, Antioch, IL 60002 | 2006-12-06 |
| 1447326004 | Stanley Jerome Witkiewicz | Dentist | 715 N Main, Antioch, IL 60002 | 2006-11-27 |
| Find all providers in zip 60002 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285157818 | Jason Thompson | Physician Assistant | 3901 Lone Tree Way, Antioch, CA 94509-6200 | 2017-07-25 |
| 1497013965 | Christina Frances Ramsden | Physician Assistant | 3707 Sunset Ln, Antioch, CA 94509-6101 | 2012-05-02 |
| 1306977814 | Malinda A Johnson | Physician Assistant | 5801 Crossings Blvd, Antioch, TN 37013-3130 | 2007-03-08 |
| 1437172848 | James Alan Jewell | Physician Assistant | 3701 Lone Tree Way, Suite 6, Antioch, CA 94509-6038 | 2006-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831707298 | Eliza Ballen | Physician Assistant | 335 Sylvan Rd, Lake Bluff, IL 60044-2562 | 2020-07-21 |
| 1477177947 | Rybecca Janovyak | Physician Assistant | 14432 High Rd, Lockport, IL 60441-9402 | 2020-06-01 |
| 1518591759 | Julie Jenkot | Physician Assistant | 333 N Michigan Ave Fl 14, Chicago, IL 60601-3901 | 2020-02-26 |
| 1801429873 | Hinjal D Jha | Physician Assistant | 22285 N Pepper Rd Ste 409, Lake Barrington, IL 60010-2542 | 2020-02-19 |
| 1770120222 | Alvina Shaikh | Physician Assistant | 4009 Warren Ave, Bellwood, IL 60104-2066 | 2019-12-03 |
| 1457997561 | Jasleen Mohini Singh | Physician Assistant | 1645a W School Street, Suite A, Clinic Entrance, Chicago, IL 60657 | 2019-11-24 |
| 1538705272 | Bethany Mae Frisby | Physician Assistant | 8630 W Golf Rd, Niles, IL 60714-5600 | 2019-11-18 |
| 1134761984 | Ella-marie Rakowski | Physician Assistant | 25 Acorn Dr, Hawthorn Woods, IL 60047-7407 | 2019-10-14 |
| 1467001859 | Timothy Omotayo Adesanya | Physician Assistant | Graham Correctional Center, 12078 Illinois Rte 185, Hilliboro, IL 62049 | 2019-09-09 |
| 1518514066 | Victoria Moore | Physician Assistant | 979 W Main St, West Dundee, IL 60118-2088 | 2019-08-20 |
| 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.