CENTRAL ILLINOIS PEDIATRIC ASSOCIATES LLC (NPI# 1174706816) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174706816 |
| Entity Type | Organization |
| Organization Name | CENTRAL ILLINOIS PEDIATRIC ASSOCIATES LLC |
| Practice Address |
2427 Maloney Dr Bloomington IL 61704-3750 |
| Mailing Address |
2427 Maloney Drive Bloomington IL 61704-3750 |
| Practice Telephone | 3096631011 |
| Mailing Telephone | 3096631011 |
| Enumeration Date | 2007-12-17 |
| Last Update Date | 2007-12-17 |
| Authorized Official Name | DR. SANJAY SAXENA (OWNER) |
| Authorized Official Telephone | 3096631011 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Street Address |
2427 MALONEY DR |
| City | BLOOMINGTON |
| State | IL |
| Zip Code | 61704-3750 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174625867 | Sanjay Saxena | Pediatrics | 2427 Maloney Dr, Bloomington, IL 61704-3750 | 2006-09-02 |
| 1861553240 | Anita C Lee | Pediatrics | 2427 Maloney Dr, Bloomington, IL 61704-3750 | 2006-12-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518430859 | Visionpoint Eye Center LLC | Optometrist | 1107 Airport Road, Bloomington, IL 61704 | 2019-01-09 |
| 1922588235 | Geethu Sabu Makil | Speech-Language Pathologist | 1039 Blueheron Way, Apt#3, Bloomington, IL 61704 | 2018-08-16 |
| 1629596812 | Mental Wellness Center Inc | Counselor | 202 N Prospect Rd Ste 207, Bloomington, IL 61704 | 2017-09-07 |
| 1649798513 | Sarah Goodner | Psychologist | 1704 Royal Pointe Drive, Bloomington, IL 61704 | 2017-08-31 |
| 1346760253 | Elizabeth Devlin | Nurse Practitioner | 25 Long Cove Ct, Bloomington, IL 61704 | 2017-06-21 |
| 1396107918 | Darla Schwertfeger | Specialist/Technologist, Other | 2104 Hedgewood Dr, Bloomington, IL 61704 | 2016-03-23 |
| 1740662949 | Oncology Hematology Associates of Central Illinois | Pharmacy | 3105 Magory Drive, Bloomington, IL 61704 | 2015-06-24 |
| 1821478967 | Kelly R Andrews | Massage Therapist | 4101 Wicker Rd, Bloomington, IL 61704 | 2015-06-03 |
| 1235522582 | All Ways Caring Services, Inc. | In Home Supportive Care | 209 S Prospect Rd, Suite 3e, Bloomington, IL 61704 | 2015-03-11 |
| 1396093977 | Bhawna Gupta | Physical Therapist | 2200 East Washington Street, Bloomington, IL 61704 | 2012-08-29 |
| Find all providers in zip 61704 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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| 1063489805 | Healthspot | Clinic/Center | 3064 E 3rd St, Bloomington, IN 47401-5425 | 2006-03-01 |
| 1427569367 | Wellness for Life | Clinic/Center | 524 N Fairview St, Bloomington, IN 47404-3774 | 2017-10-18 |
| 1811385925 | Activate Healthcare - Monroe Clinic | Clinic/Center | 119 W 7th St, Bloomington, IN 47404-3926 | 2014-12-26 |
| 1285060947 | Kellie Lyn Dunkin | Clinic/Center | 451 S Park Ridge Rd, Suite 101, Bloomington, IN 47401-8589 | 2013-09-25 |
| 1295005445 | Chestnut Health System, Inc | Clinic/Center | 1003 Martin Luther King Dr, Bloomington, IL 61701-1429 | 2012-01-05 |
| 1669752960 | Immanuel Health Center | Clinic/Center | 502 S Morris Ave, Suite A, Bloomington, IL 61701-4884 | 2011-08-18 |
| 1265614242 | Advacare Clinics,ltd | Clinic/Center | 5001 American Blvd W, Ste.945, Bloomington, MN 55437-1108 | 2007-11-30 |
| 1528108941 | Cook Family Health Center | Clinic/Center | 402 N Rogers St, Bloomington, IN 47404-3740 | 2007-02-07 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 61704 |
Please comment or provide details below to improve the information on CENTRAL ILLINOIS PEDIATRIC ASSOCIATES LLC.
| 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.