ILLINOIS/INDIANA EM-I MEDICAL SERVICES, SC (NPI# 1457503591) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1457503591 |
Entity Type | Organization |
Organization Name | ILLINOIS/INDIANA EM-I MEDICAL SERVICES, SC |
Practice Address |
1400 W Park St Urbana IL 61801-2334 |
Mailing Address |
Po Box 37757 Philadelphia PA 19101-5057 |
Practice Telephone | 2173372000 |
Practice Fax Number | 2173372930 |
Mailing Telephone | 8007321066 |
Mailing Fax Number | 6309414333 |
Enumeration Date | 2008-10-21 |
Last Update Date | 2015-07-22 |
Authorized Official Name | DR. DOUGLAS P WEBSTER (OWNER) |
Authorized Official Telephone | 8007321066 |
Authorized Official Credential | DO |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 363A00000X | Physician Assistant | IL | Physician Assistants & Advanced Practice Nursing Providers | |
Y | 363L00000X | Nurse Practitioner | IL | Physician Assistants & Advanced Practice Nursing Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619379534 | Illinois/indiana Em-i Medical Services, Sc | Physician Assistant | 1324 N Sheridan Rd, Waukegan, IL 60085-2161 | 2014-09-23 |
1841511995 | Illinois/indiana Em-i Medical Services, Sc | Nurse Practitioner | 2100 Madison Ave, Granite City, IL 62040-4701 | 2010-06-11 |
1700114824 | Illinois/indiana Em-i Medical Services, Sc | Nurse Practitioner | 1451 N Gardner St, Scottsburg, IN 47170-7751 | 2009-12-01 |
Street Address |
1400 W PARK ST |
City | URBANA |
State | IL |
Zip Code | 61801-2334 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801862461 | Shamim Sadiq | Internal Medicine | 1400 W Park St, Urbana, IL 61801-2334 | 2006-02-24 |
1548873938 | Audra Leigh Cisna | Dietitian, Registered | 1400 W Park St, Urbana, IL 61801-2334 | 2020-08-26 |
1689200750 | Holly Tompkins | Dietitian, Registered | 1400 W Park St, Urbana, IL 61801-2334 | 2020-03-20 |
1417419045 | Latifa Omran | Technician/Technologist | 1400 W Park St, Urbana, IL 61801-2334 | 2019-04-02 |
1588134084 | Lauren Dowd | Dietitian, Registered | 1400 W Park St, Urbana, IL 61801 | 2018-11-28 |
1053801514 | Sarah Kristine Farison | Speech-Language Pathologist | 1400 W Park St, Urbana, IL 61801-2334 | 2018-05-10 |
1316437882 | Tian Lan | Physical Therapist | 1400 W Park St, Urbana, IL 61801-2334 | 2018-05-10 |
1659884476 | Osf Healthcare System | General Acute Care Hospital | 1400 W Park St, Urbana, IL 61801 | 2017-11-15 |
1093228835 | Osf Healthcare System | Ambulance | 1400 W Park St, Urbana, IL 61801 | 2017-11-15 |
1649783473 | Osf Healthcare System | General Acute Care Hospital | 1400 W Park St, Urbana, IL 61801 | 2017-11-15 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417566084 | Avani Sushilkumar Mohta | Internal Medicine | Carle Foundation Hospital, 611 W. Park Street, Urbana, IL 61801 | 2020-07-29 |
1922617133 | Recovery Concepts Urbana, LLC | Clinic/Center | 710 W. Killarney St., Urbana, IL 61801 | 2020-07-24 |
1447877089 | Muhammad Khalid Abbas | Internal Medicine | 611 W Park St Urbana, Urbana, IL 61801 | 2020-06-30 |
1003430166 | Conlan Joseph Pierce | Surgery | 601 W Park St, Urbana, IL 61801 | 2020-06-04 |
1568090900 | Luke Andrew Fenlon | Student in an Organized Health Care Education/Training Program | Carle Forum Lower Level, Mc-474, 611 West Park Street, Urbana, IL 61801 | 2020-03-31 |
1912559691 | Ali Baltaji | Internal Medicine | 101 N Busey Apt 7, Urbana, IL 61801 | 2019-07-12 |
1821510918 | Pallavi Pradeep | Internal Medicine | Imrp, Carle Foundation Hospital, 611 W Park Street, Urbana, IL 61801 | 2017-07-11 |
1093236002 | Angela Lynn Devaney | Speech-Language Pathologist | 1400 W Park, Presence Covenant Medical Center, Urbana, IL 61801 | 2017-06-29 |
1346775236 | Jennifer Garcia | Student in an Organized Health Care Education/Training Program | Carle Foundation Hospital, 611 W. Park Street, Urbana, IL 61801 | 2017-04-27 |
1467992537 | Amber Kristine Davis | Speech-Language Pathologist | 1400 W. Park, Presence Health Medical Center, Urbana, IL 61801 | 2017-03-08 |
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Taxonomy Code | 363L00000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679030852 | Braden J Shaffer | Nurse Practitioner | 1400 W Park St Ste 424b, Urbana, IL 61801-2334 | 2019-02-25 |
1396138830 | Noemi Shilts | Nurse Practitioner | 610 N. Lincoln Ave, Urbana, IL 61801-2500 | 2015-03-09 |
1003165564 | Lindy Drollinger | Nurse Practitioner | 610 N. Lincoln Ave., Neurosurgery, Urbana, IL 61801-2500 | 2012-08-30 |
1659407088 | Peggi J White | Nurse Practitioner | 204 West University, Carle Addiction Recovery Center, Urbana, IL 61801 | 2007-02-27 |
1861578320 | Martha A Guyon | Nurse Practitioner | 602 W, University Avenue, Ob/gyn, Urbana, IL 61801 | 2006-10-27 |
1265032221 | Lindsay Roberts | Nurse Practitioner | 1818 E Windsor Rd, Urbana, IL 61802-9566 | 2020-10-29 |
1730786161 | Donnetta Burgess | Nurse Practitioner | 509 W University Ave, Urbana, IL 61801-1645 | 2020-10-08 |
1134730310 | Whitney Waterman | Nurse Practitioner | 1818 E Windsor Rd, Urbana, IL 61802-9566 | 2020-08-12 |
1851918874 | Jeffrey Flach | Nurse Practitioner | 611 W Park St, Urbana, IL 61801-2529 | 2020-06-26 |
1134758758 | Ellen R Leskovisek | Nurse Practitioner | 611 W. Park St., Urbana, IL 61801 | 2020-04-06 |
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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.