FAMILY MEDICINE SPECIALISTS, INC (NPI# 1497079636) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497079636 |
| Entity Type | Organization |
| Organization Name | FAMILY MEDICINE SPECIALISTS, INC |
| Practice Address |
431 W Liberty St Wauconda IL 60084-2452 |
| Mailing Address |
2980 N Beverly Glen Cir Suite 301 Los Angeles CA 90077-1726 |
| Practice Telephone | 8475262151 |
| Mailing Telephone | 3104749809 |
| Mailing Fax Number | 8886523017 |
| Enumeration Date | 2010-03-17 |
| Last Update Date | 2011-03-01 |
| Authorized Official Name | JENNIFER BELLUCI-JACKSON (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 8475262151 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | FAMILY MEDICINE SPECIALISTS, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992005870 | Family Medicine Specialists, Inc | Family Medicine | 9700 N Main St, Richmond, IL 60071-7716 | 2010-10-26 |
| Street Address |
431 W LIBERTY ST |
| City | WAUCONDA |
| State | IL |
| Zip Code | 60084-2452 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356335996 | David J Alengo | Family Medicine | 431 W Liberty St, Wauconda, IL 60084-2452 | 2005-09-09 |
| 1104423094 | Corrie Mcmahon | Nurse Practitioner | 431 W Liberty St, Wauconda, IL 60084-2452 | 2020-10-05 |
| 1093349391 | Celestia Arendall Nielsen | Nurse Practitioner | 431 W Liberty St, Wauconda, IL 60084-2452 | 2020-02-25 |
| 1881242725 | Nicole Hendrickson | Nurse Practitioner | 431 W Liberty St, Wauconda, IL 60084-2452 | 2019-09-03 |
| 1619529138 | Wendy Marie Belletynee | Nurse Practitioner | 431 W Liberty St, Wauconda, IL 60084-2452 | 2019-07-15 |
| 1508336918 | Lisabeth N. Morrisroe | Nurse Practitioner | 431 W Liberty St, Wauconda, IL 60084-2452 | 2018-11-28 |
| 1053800516 | Karen Anne Fermin Violago | Nurse Practitioner | 431 W Liberty St, Wauconda, IL 60084-2452 | 2018-05-09 |
| 1114415205 | Kaitlyn Jamie Lundgren | Nurse Practitioner | 431 W Liberty St, Wauconda, IL 60084 | 2018-04-25 |
| 1396246450 | Jessica Helen Partyka | Nurse Practitioner | 431 W Liberty St, Wauconda, IL 60084-2452 | 2018-02-23 |
| 1841718087 | Michelle Naurecki | Nurse Practitioner | 431 W Liberty St, Wauconda, IL 60084 | 2017-09-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891305660 | Reynaldo D Dado | Physical Medicine & Rehabilitation | 2751 Cedar Creek Cut-off Rd, Wauconda, IL 60084 | 2020-08-05 |
| 1841719705 | Aneena Susan Philip | Pharmacist | 547 W Liberty Street, Wauconda, IL 60084 | 2017-09-12 |
| 1164897476 | Laura Dobson | Nurse Practitioner | 450 West Route 22, Wauconda, IL 60084 | 2015-12-11 |
| 1366816514 | Family Medicine Specialists, S.c. | Non-Pharmacy Dispensing Site | 431 W Liberty Street, Wauconda, IL 60084 | 2015-11-25 |
| 1922408822 | Accuvision Inc | Optometrist | 573 W. Liberty, Wauconda, IL 60084 | 2014-08-27 |
| 1982041851 | Sara J Hollis | Counselor | 227 N. Main Street, Wauconda, IL 60084 | 2013-05-31 |
| 1639321482 | Stacie Wharton | Physician Assistant | 431 West Liberty Street, Wauconda, IL 60084 | 2008-10-10 |
| 1336207893 | Kurt Allan Bohl | Dentist | 469 West Liberty Street, Suite C, Wauconda, IL 60084 | 2006-12-05 |
| 1316013386 | William Richard Womer | Chiropractor | 604 E Liberty St, Wauconda, IL 60084 | 2006-11-28 |
| 1639283583 | Luis Planas | Internal Medicine | 363 N Main St, Wauconda, IL 60084 | 2006-08-18 |
| Find all providers in zip 60084 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366816514 | Family Medicine Specialists, S.c. | Non-Pharmacy Dispensing Site | 431 W Liberty Street, Wauconda, IL 60084 | 2015-11-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013520113 | Pmr Illinois Holding, LLC | Non-Pharmacy Dispensing Site | 600 E Sibley Blvd, Dolton, IL 60419-2599 | 2020-08-28 |
| 1386255123 | Dermatology Associates Ltd | Non-Pharmacy Dispensing Site | 13401 S Ridgeland Ave, Palos Heights, IL 60463-1898 | 2020-08-14 |
| 1497398648 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 853 W Jackson Plaza, Morton, IL 61550 | 2019-10-21 |
| 1902449382 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 1730 Bradford Ln, Normal, IL 61761-1297 | 2019-10-18 |
| 1073173134 | Shobhana Patodia | Non-Pharmacy Dispensing Site | 1111 Superior St Ste 206, Melrose Park, IL 60160-4156 | 2019-06-19 |
| 1215494620 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 3653 N Vermilion Dr, Danville, IL 61832 | 2019-02-22 |
| 1306303714 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 520 N Cunningham Avenue, 5 Points Shopping Center, Urbana, IL 61802 | 2019-02-22 |
| 1124585534 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 5209 W. War Memorial Drive, Grand Prairie Mall, Peoria, IL 61615-9250 | 2019-02-22 |
| 1871050237 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 508 Iaa Dr, Bloomington, IL 61701-2216 | 2019-02-21 |
| 1518424969 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 2901 Columbus St, Ottawa, IL 61350-1009 | 2019-02-21 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on FAMILY MEDICINE SPECIALISTS, INC.
| 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.