HERITAGE PRIMARY CARE, S.C. (NPI# 1295923191) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295923191 |
| Entity Type | Organization |
| Organization Name | HERITAGE PRIMARY CARE, S.C. |
| Practice Address |
1600 N Randall Rd Suite 155 Elgin IL 60123-7803 |
| Practice Telephone | 8474889589 |
| Practice Fax Number | 8479315173 |
| Mailing Telephone | 8474889589 |
| Mailing Fax Number | 8479315173 |
| Enumeration Date | 2007-10-05 |
| Last Update Date | 2015-01-07 |
| Authorized Official Name | DR. ARCHANA GOEL (PRESIDENT) |
| Authorized Official Telephone | 8474889589 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 036092129 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036092129 | 05 | |
| IL | BCBS | 0004522347 | 01 |
| Street Address |
1600 N RANDALL RD SUITE 155 |
| City | ELGIN |
| State | IL |
| Zip Code | 60123-7803 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336219682 | Karen C Catching | Internal Medicine | 1600 N Randall Rd, Elgin, IL 60123-7803 | 2006-11-08 |
| 1598218125 | Bailey Ellington | Nurse Practitioner | 1600 N Randall Rd, 400, Elgin, IL 60123-7803 | 2016-08-01 |
| 1578935896 | Jenny Brophy | Physician Assistant | 1600 N Randall Rd, Suite 400, Elgin, IL 60123-7803 | 2015-10-26 |
| 1306263561 | Andrew J Thompson | Dermatology | 1600 N Randall Rd, Suite 400, Elgin, IL 60123 | 2014-03-26 |
| 1508288549 | Suburban Orthopaedics | Orthopaedic Surgery | 1600 N Randall Rd, Elgin, IL 60123-7803 | 2014-01-10 |
| 1063737658 | Suburban Orthopaedics | Orthopaedic Surgery | 1600 N Randall Rd, Elgin, IL 60123-7800 | 2010-04-07 |
| 1851557102 | Margaret H Fruhbauer | Internal Medicine | 1600 N Randall Rd, Suite 115, Elgin, IL 60123-7803 | 2008-08-05 |
| 1942473947 | Stefanie A Ali | Dermatology | 1600 N Randall Rd, Suite 400, Elgin, IL 60123 | 2008-04-10 |
| 1467624528 | Jennifer R Hensley | Dermatology | 1600 N Randall Rd, Suite 400, Elgin, IL 60123 | 2008-03-28 |
| 1477691640 | Midwest Oncology Hematology Ltd | Internal Medicine | 1600 N Randall Rd, Ste. 115, Elgin, IL 60123-2306 | 2007-02-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629625736 | Edna Lopez | Social Worker | 1140 N. Mclean Blvd #1, Elgin, IL 60123 | 2019-08-22 |
| 1003472259 | Katelyn Lee O'connell | Counselor | 695 S. Sate Street, Elgin, IL 60123 | 2019-05-14 |
| 1598235152 | Katie Elizabeth Dwyer | Counselor | 695 S. State Street, Elgin, IL 60123 | 2018-11-27 |
| 1174002778 | James M Accetta | Counselor | 52 Surry Drive, Elgin, IL 60123 | 2018-08-14 |
| 1770086175 | Griswold Home Care | Adult Companion | 707 A Davis Road, Suite 203, Elgin, IL 60123 | 2018-03-12 |
| 1003315706 | Danielle Bryant | Nurse Practitioner | 745 Fletcher Dr Ste 101, Elgin, IL 60123 | 2018-02-08 |
| 1912421470 | Deborah Foshager | Counselor | 680 Shenandoah Trail, Elgin, IL 60123 | 2017-07-26 |
| 1760903470 | Miguel Camargo | Specialist/Technologist | 12 N Aldine St, Elgin, IL 60123 | 2017-07-03 |
| 1134658594 | David Sommer | Counselor | 1460 Umbdenstock Rd, Elgin, IL 60123 | 2017-06-08 |
| 1649719618 | Faheem Unisa Syed | Clinical Nurse Specialist | 1990 Larkin Ave., Elgin, IL 60123 | 2017-02-23 |
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| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164969796 | Kathleen Antonetti, Md, LLC | Internal Medicine | 305 Bluestem Dr, Elgin, SC 29045-2103 | 2017-01-20 |
| 1871728675 | Imran Husain Kazmi | Internal Medicine | 1600 N Randall Rd Ste 225, Elgin, IL 60123-7805 | 2009-05-22 |
| 1871785923 | Ashima Salwan | Internal Medicine | 2371 Bowes Rd Ste 100, Elgin, IL 60123-5543 | 2007-08-13 |
| 1366634487 | Sharon L Duval | Internal Medicine | 745 Fletcher Dr Ste 101-102, Elgin, IL 60123 | 2007-08-13 |
| 1730236035 | Angel Gomez-galan | Internal Medicine | 1140 N Mclean Blvd, Ste E, Elgin, IL 60123-1782 | 2007-01-05 |
| 1013074442 | Aamir A Memon | Internal Medicine | 1710 N Randall Rd Ste 330, Elgin, IL 60123-9405 | 2007-01-03 |
| 1326101544 | Advanced Clinic, Ltd. | Internal Medicine | 1600 N Randall Road, Suite 135, Elgin, IL 60123-7810 | 2006-12-18 |
| 1700952140 | Devendra U Shah | Internal Medicine | 484 Summit St, Elgin, IL 60120-3829 | 2006-11-28 |
| 1336219682 | Karen C Catching | Internal Medicine | 1600 N Randall Rd, Elgin, IL 60123-7803 | 2006-11-08 |
| 1538250725 | Roseanne Cullen | Internal Medicine | 515 N Highway 95, Elgin, TX 78621-1009 | 2006-09-27 |
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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.