WESTERN ILLINOIS SPORTS MEDICINE AND ORTHOPEDIC CENTER (NPI# 1558496265) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558496265 |
| Entity Type | Organization |
| Organization Name | WESTERN ILLINOIS SPORTS MEDICINE AND ORTHOPEDIC CENTER |
| Practice Address |
927 Broadway St Ste 104 Quincy IL 62301-2728 |
| Practice Telephone | 2172248955 |
| Practice Fax Number | 2172238917 |
| Mailing Telephone | 2172248955 |
| Mailing Fax Number | 2172238917 |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | RONALD DEE WHEELER (PRESIDENT) |
| Authorized Official Telephone | 2172248955 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | IL | Other Service Providers |
| Street Address |
927 BROADWAY ST STE 104 |
| City | QUINCY |
| State | IL |
| Zip Code | 62301-2728 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356969471 | Lutheran Child and Family Service of Illinois | Foster Care Agency | 1400 N. 30th St, Quincy, IL 62301 | 2020-07-07 |
| 1134749716 | Bethany Nicole Jumps | Pharmacist | Broadway St & N 11th St, Quincy, IL 62301 | 2020-04-23 |
| 1043844293 | S.crider Construction An Supply Corp. | Contractor | 529 Woodbridge Dr., Quincy, IL 62301 | 2020-02-26 |
| 1245862002 | Quincy Physicians & Surgeons Clinic, Sc | Clinic/Center | 3301 Broadway St., Quincy, IL 62301 | 2020-02-10 |
| 1043851488 | West Central Illinois Nutrition | In Home Supportive Care | 639 York St. Room 333, Quincy, IL 62301 | 2019-10-07 |
| 1861986549 | Quincy Physicians & Surgeons Clinic, Sc | Internal Medicine | 3347 Broadway St, Quincy, IL 62301 | 2018-06-18 |
| 1194255083 | Michael Andrew Behrens | Nurse Practitioner | Broadway and 11th Street, Quincy, IL 62301 | 2017-06-14 |
| 1770987323 | Kirsty Yvonne Reed | Counselor | 205 S. 24th Street, Chaddock, Quincy, IL 62301 | 2014-10-10 |
| 1114234499 | Dale D. Shahan Dds Ltd | Dentist | 636 Hampshire Suite 102, Quincy, IL 62301 | 2010-09-08 |
| 1730314071 | James D Kaufmann | Pharmacist | 14th & Broadway, Quincy, IL 62301 | 2009-05-15 |
| Find all providers in zip 62301 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164797239 | Maura E Ziegler | Specialist | 350 Hancock St, Quincy, MA 02171-2439 | 2012-03-21 |
| 1346510310 | Mountain Physical Therapy | Specialist | 20 Crescent St, B, Quincy, CA 95971-9118 | 2012-01-09 |
| 1962782789 | Beth M Baker | Specialist | 67 Coddington St Ste 103, Quincy, MA 02169-4511 | 2011-08-24 |
| 1295015675 | Carrie Anne Weber | Specialist | 11 D St Se, Quincy, WA 98848-1433 | 2011-08-17 |
| 1043470792 | Cynthia Jo Rosenkoetter | Specialist | 2810 Lind St, Quincy, IL 62301-3507 | 2008-06-16 |
| 1144404104 | Khosro Tigrani | Specialist | 318 Lincoln Hl Nw, Quincy, IL 62301-4496 | 2007-12-26 |
| 1306068275 | Jimmie Dean Copeland Jr. | Specialist | 104 E. Washington Street, Suite E., Quincy, FL 32351 | 2007-05-02 |
| 1730214065 | Reynaldo Pesina | Specialist | 76 Cresent Way, Quincy, CA 95970 | 2007-02-23 |
| 1043363542 | Sands Traveler Pt, Inc. | Specialist | 76 Cresent, Quincy, CA 95971 | 2007-01-19 |
| 1982771978 | Family Practice of Chiropractic, PC | Specialist | 112 Mayor Thomas J Mcgrath Hwy, Quincy, MA 02169-4607 | 2006-11-29 |
| Find all providers in QUINCY | ||||
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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.