BROMENN PHYSICIANS MANAGEMENT CORPORATION (NPI# 1285903799) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285903799 |
| Entity Type | Organization |
| Organization Name | BROMENN PHYSICIANS MANAGEMENT CORPORATION |
| Other Organization Name | ADVOCATE MEDICAL GROUP BROMENN |
| Practice Address |
1302 Franklin Ave Suite 1100 Normal IL 61761-3551 |
| Mailing Address |
701 Lee St Suite 300 Des Plaines IL 60016-4539 |
| Practice Telephone | 3092682727 |
| Practice Fax Number | 3092682759 |
| Mailing Telephone | 8473905900 |
| Mailing Fax Number | 8473905922 |
| Enumeration Date | 2011-12-29 |
| Last Update Date | 2011-12-29 |
| Authorized Official Name | IAN STEWART (VP BUS SYS, FINANCE, OPS) |
| Authorized Official Telephone | 8473905453 |
| Is Organization Subpart | Y |
| Parent Organization Name | ADVOCATE HEALTH AND HOSPITALS CORPORATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers | ||
| N | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
Allopathic & Osteopathic Physicians | ||
| N | 207RR0500X |
Internal Medicine Specialization: Rheumatology |
Allopathic & Osteopathic Physicians | ||
| N | 207RS0010X |
Internal Medicine Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 207Y00000X | Otolaryngology | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 208100000X | Physical Medicine & Rehabilitation | Allopathic & Osteopathic Physicians | ||
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Advocate Medical Group Bromenn | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740207109 | Bromenn Physicians Management Corporation | Family Medicine | 403 W Virginia Ave, Normal, IL 61761-3666 | 2006-07-15 |
| 1922377431 | Bromenn Physicians Management Corporation | Internal Medicine | 1302 Franklin Ave, Suite 4500, Normal, IL 61761-3551 | 2011-12-29 |
| 1487731220 | Bromenn Physicians Management Corporation | Family Medicine | 115 E Walnut St, Fairbury, IL 61739-1516 | 2006-11-01 |
| 1629155460 | Bromenn Physicians Management Corporation | Family Medicine | 105 S Major St, Eureka, IL 61530-1246 | 2006-11-01 |
| 1235216060 | Bromenn Physicians Management Corporation | Family Medicine | 385 S Orange St, El Paso, IL 61738-1613 | 2006-11-01 |
| Street Address |
1302 FRANKLIN AVE SUITE 1100 |
| City | NORMAL |
| State | IL |
| Zip Code | 61761-3551 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063419679 | John D Fulk | Physician Assistant | 1302 Franklin Ave, Suite 4800, Normal, IL 61761-3551 | 2005-06-29 |
| 1235686759 | Brooke Davis | Nurse Practitioner | 1302 Franklin Ave, Suite 4800, Normal, IL 61761-3551 | 2016-09-01 |
| 1043676109 | Amy J Stites | Physician Assistant | 1302 Franklin Ave, Suite 4800, Normal, IL 61761-3551 | 2016-01-05 |
| 1255700316 | Abigail G Cervantes | Obstetrics & Gynecology | 1302 Franklin Ave, Suite 2800, Normal, IL 61761-6526 | 2015-09-18 |
| 1700252228 | Prairieland Outpatient Diagnostic Center, LLC | Anesthesiology | 1302 Franklin Ave, Suite 1000, Normal, IL 61761-3551 | 2015-08-19 |
| 1467860445 | Christie Rocke | Nurse Practitioner | 1302 Franklin Ave, Suite 3400, Normal, IL 61761-3551 | 2014-07-23 |
| 1114343225 | Jennifer Lanz | Nurse Practitioner | 1302 Franklin Ave, Suite 4500, Normal, IL 61761-3551 | 2014-03-13 |
| 1396189411 | Consulting Anesthesiologists LLC | Anesthesiology | 1302 Franklin Ave, Normal, IL 61761-3551 | 2013-04-19 |
| 1922377431 | Bromenn Physicians Management Corporation | Internal Medicine | 1302 Franklin Ave, Suite 4500, Normal, IL 61761-3551 | 2011-12-29 |
| 1033494455 | Maneesha T Joseph | Registered Nurse | 1302 Franklin Ave, Suite 3400, Normal, IL 61761-3551 | 2011-10-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629681796 | Brittany Nicole Mekley | Nurse Practitioner | 201 N. University, Normal, IL 61761 | 2020-08-28 |
| 1679108971 | Krystal Halliday | Occupational Therapist | 1815 N Towanda Barnes Rd, Normal, IL 61761 | 2020-03-06 |
| 1265915474 | Laine E Burek | Nurse Practitioner | 1765 Bradford Ln., Normal, IL 61761 | 2018-09-13 |
| 1801389986 | Ashley Michelle James | Specialist/Technologist | 347 S. University St, Normal, IL 61761 | 2018-06-12 |
| 1447750708 | Shelley R. Ruch | Specialist/Technologist, Other | 1604 Visa Drive, Ste 1, Normal, IL 61761 | 2018-02-13 |
| 1497275069 | Mclean County Nursing Home | Non-emergency Medical Transport (VAN) | 901 N. Main St, Normal, IL 61761 | 2017-06-23 |
| 1235673666 | Megan Threm | Registered Nurse | 900 Franklin Ave Community Health Care Clinic, Normal, IL 61761 | 2016-12-04 |
| 1437513553 | Tiesha Smith | Specialist | 1800 Rockingham Dr, Apt 1d, Normal, IL 61761 | 2016-04-06 |
| 1285031658 | New Day Recovery | Community/Behavioral Health | 402 Summit, Normal, IL 61761 | 2014-12-01 |
| 1174927701 | Alyssa Marie Bruck | Occupational Therapist | 700 N Walnut St, Normal, IL 61761 | 2014-10-10 |
| Find all providers in zip 61761 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467074138 | Carle West Physician Group Inc | Family Medicine | 1302 Franklin Ave Ste 3400, Normal, IL 61761-6523 | 2020-05-15 |
| 1023472636 | Ashraf Abdeljaber | Family Medicine | 1304 Franklin Ave Ste 380, Normal, IL 61761-3558 | 2016-04-09 |
| 1467834317 | Karen Akemi Sung Putty | Family Medicine | 1300 Franklin Ave Ste 110, Normal, IL 61761-3799 | 2015-06-26 |
| 1629311220 | Gbemisola Tolulope Olorode | Family Medicine | 1300 Franklin Ave Ste 380, Normal, IL 61761-4266 | 2013-04-02 |
| 1922206929 | Elaine Welch | Family Medicine | 2200 Fort Jesse Rd Ste 110, Normal, IL 61761-6286 | 2007-07-11 |
| 1083724405 | James Steven Vales | Family Medicine | 109 Veronica Way, Normal, IL 61761-1854 | 2006-08-30 |
| 1972619526 | Todd Owen Kettering | Family Medicine | 1300 Franklin Avenue, Suite 100, Normal, IL 61761 | 2006-08-23 |
| 1548288327 | Marcia K. Hauter | Family Medicine | 1302 Franklin Ave Lowr Level, Normal, IL 61761-3551 | 2006-07-18 |
| 1740207109 | Bromenn Physicians Management Corporation | Family Medicine | 403 W Virginia Ave, Normal, IL 61761-3666 | 2006-07-15 |
| 1790744555 | Victoria J Brockhouse | Family Medicine | 2540 College and University, Normal, IL 61790-2540 | 2006-03-21 |
| Find all providers in NORMAL | ||||
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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.