MARC R. DEJONG (NPI# 1477549541) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477549541 |
| Entity Type | Individual |
| Full Name | MARC R. DEJONG |
| Credential | MD |
| Practice Address |
800 N 1st St Springfield IL 62702-3719 |
| Mailing Address |
1025 S 6th St Springfield IL 62703-2403 |
| Practice Telephone | 2175287541 |
| Practice Fax Number | 2175271103 |
| Mailing Telephone | 2175287541 |
| Mailing Fax Number | 2175288962 |
| Enumeration Date | 2005-09-23 |
| Last Update Date | 2020-05-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 036114259 | IL | Allopathic & Osteopathic Physicians |
| Y | 207RS0010X |
Internal Medicine Specialization: Sports Medicine |
036114259 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036114259 | 05 |
| Street Address |
800 N 1ST ST |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62702-3719 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154321222 | Piero Capecci | Orthopaedic Surgery | 800 N 1st St, Springfield, IL 62702-3719 | 2005-07-29 |
| 1811504087 | Dylan S Mckinney | Nurse Practitioner | 800 N 1st St, Springfield, IL 62702-3719 | 2020-09-30 |
| 1407460512 | Sarah L Nunez | Physical Therapist | 800 N 1st St, Springfield, IL 62702-3778 | 2020-09-04 |
| 1720601784 | Dorothy V Pham | Physician Assistant | 800 N 1st St, Springfield, IL 62702-3719 | 2020-05-26 |
| 1922644137 | Gregory L Young | Specialist/Technologist, Other | 800 N 1st St, Springfield, IL 62702-3719 | 2019-11-22 |
| 1912550468 | Mary R. Mullins | Nurse Practitioner | 800 N 1st St, Springfield, IL 62702-3719 | 2019-07-23 |
| 1588224927 | Ashley M. Boyle | Physical Therapist | 800 N 1st St, Springfield, IL 62702-3719 | 2019-06-18 |
| 1013572114 | Kendra Miller | Physical Therapy Assistant | 800 N 1st St, Springfield, IL 62702-3778 | 2019-05-03 |
| 1801451067 | Anna Neumann | Occupational Therapy Assistant | 800 N 1st St, Springfield, IL 62702-3719 | 2019-05-03 |
| 1316408776 | Jennifer A. Drennan | Physical Therapist | 800 N 1st St, Springfield, IL 62702-3719 | 2019-03-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457866519 | Mohammad Jamal Uddin Ansari | Internal Medicine | 751 N Rutledge St Ste 400, Springfield, IL 62702 | 2017-12-11 |
| 1588105811 | Mickey Graphia | Surgery | 701 N 1st St # D346, Springfield, IL 62702 | 2017-03-20 |
| 1376908913 | Abdul Hannan | Internal Medicine | 315 W Carpenter St # B, Springfield, IL 62702 | 2015-12-28 |
| 1871986414 | Rachel Hoselton | Nurse Practitioner | 400 N 9th St Fl 4, Springfield, IL 62702 | 2015-03-06 |
| 1548697774 | Alyssa Wilson | Behavioral Analyst | 232 Bruns Lane, One Sparcenter Plaza, Springfield, IL 62702 | 2013-10-02 |
| 1174965446 | Amy Wilson | Speech-Language Pathologist | 2120 West Washington Street, Springfield, IL 62702 | 2013-07-26 |
| 1275898116 | Pele Boutrous Dina | Pediatrics | 415 N 9th St # 4w16, Springfield, IL 62702 | 2012-07-06 |
| 1427327733 | Brook D Croke | Genetic Counselor, MS | 400 N. 9th Street, 3rd Floor Clinic B, Springfield, IL 62702 | 2011-12-16 |
| 1629352604 | Renae M Sanchez | Pharmacist | 3216 East Clearlake Ave, Springfield, IL 62702 | 2011-10-07 |
| 1982915302 | William Leland Zelkovich | Radiology | 701 N 1st, Springfield, IL 62702 | 2010-06-30 |
| Find all providers in zip 62702 | ||||
| Taxonomy Code | 207RS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Sports Medicine |
| An internist trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the healthcare of the individual. |
| 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 |
|---|---|---|---|---|
| 1487682654 | James J Mauti | Internal Medicine | 406 Milltown Rd, Springfield, NJ 07081-2445 | 2006-06-28 |
| 1356713572 | Western New England University | Internal Medicine | 1215 Wilbraham Rd, Springfield, MA 01119-2612 | 2015-10-27 |
| 1619018702 | Milltown Medical Associates LLC | Internal Medicine | 406 Milltown Rd, Springfield, NJ 07081-2445 | 2007-02-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659874261 | Relive Physician Services LLC | Internal Medicine | 333 Waukegan Rd Ste G, Glenview, IL 60025-5122 | 2018-03-10 |
| 1003171596 | Midamerica Orthopaedics, S.c. | Internal Medicine | 1419 Peterson Rd, Libertyville, IL 60048-1001 | 2012-07-10 |
| 1528255049 | Naveed H Elahi Dc Sc | Internal Medicine | 1037 E Woodfield Rd, Schaumburg, IL 60173-4706 | 2007-09-28 |
| 1245359041 | Michael Phillip Fragen | Internal Medicine | 1615 S Norbury Ave, Lombard, IL 60148-6182 | 2007-03-29 |
| 1922157635 | Stephen Adams | Internal Medicine | 259 E Erie St # 100, Chicago, IL 60611-2930 | 2007-01-10 |
| 1023020989 | Ronald Anthony Hickombottom | Internal Medicine | 728 W Jackson Blvd Apt 306, Chicago, IL 60661-5405 | 2006-08-12 |
| 1285612259 | Kathleen M. Weber | Internal Medicine | 1611 W. Harrison, Suite 400, Chicago, IL 60612 | 2006-01-09 |
| 1275195059 | Sure Work Health Clinic Ltd | Internal Medicine | 830 N Ashland Ave, Chicago, IL 60622-5684 | 2019-07-02 |
| 1386102903 | Sure Work Health Clinic | Internal Medicine | 6222 S Pulaski Rd, Chicago, IL 60629-4610 | 2019-03-04 |
| 1235557877 | Angelo M. Savino | Internal Medicine | 720 Florsheim Dr, Libertyville, IL 60048 | 2014-04-01 |
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| City | SPRINGFIELD |
| Zip Code | 62702 |
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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.