PROVENA MERCY MEDICAL CENTER (NPI# 1639221377) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639221377 |
| Entity Type | Organization |
| Organization Name | PROVENA MERCY MEDICAL CENTER |
| Practice Address |
1325 N Highland Ave Aurora IL 60506-1449 |
| Practice Telephone | 6308592222 |
| Mailing Telephone | 6308592222 |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DEBBIE POPP (HUMAN RESOURCES) |
| Authorized Official Telephone | 6308012690 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 273R00000X | Psychiatric Unit | IL | Hospital Units |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912253568 | Provena Mercy Medical Center | General Acute Care Hospital | 136 Spuhler Dr, Batavia, IL 60510-1625 | 2012-08-01 |
| 1366727935 | Provena Mercy Medical Center | Obstetrics & Gynecology | 1325 N Highland Ave, Aurora, IL 60506-1449 | 2011-10-14 |
| 1336285527 | Provena Mercy Medical Center | General Acute Care Hospital | 1325 N Highland Ave, Aurora, IL 60506-1449 | 2007-01-29 |
| Street Address |
1325 N HIGHLAND AVE |
| City | AURORA |
| State | IL |
| Zip Code | 60506-1449 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053310417 | Aurora Radiology Consultants, S.c. | Radiology | 1325 N Highland Ave, Aurora, IL 60506-1449 | 2005-07-19 |
| 1790307999 | Dorota Teresa Kruczek | Counselor | 1325 N Highland Ave, Aurora, IL 60506-1449 | 2020-05-11 |
| 1255967709 | Kathryn Ann Mckenna | Social Worker | 1325 N Highland Ave, Aurora, IL 60506-1449 | 2020-03-17 |
| 1134778152 | Robert W Healy | Social Worker | 1325 N Highland Ave, Aurora, IL 60506-1449 | 2019-09-11 |
| 1548721673 | Kristina Thomas | Social Worker | 1325 N Highland Ave, Aurora, IL 60506-1449 | 2019-03-29 |
| 1811454333 | Meagan Gabrielle Knight | Counselor | 1325 N Highland Ave, Aurora, IL 60506-1449 | 2019-02-21 |
| 1194298463 | Sarah Kestner | Dietitian, Registered | 1325 N Highland Ave, Aurora, IL 60506-1449 | 2019-01-09 |
| 1306318027 | Tianna Miulli | Counselor | 1325 N Highland Ave, Aurora, IL 60506-1449 | 2018-12-19 |
| 1831649029 | Jatame Carden | Physician Assistant | 1325 N Highland Ave, Aurora, IL 60506-1449 | 2016-10-11 |
| 1881141125 | Tracy Butler | Nurse Practitioner | 1325 N Highland Ave, Aurora, IL 60506-1449 | 2016-09-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225678121 | Yvette Velazquez | Non-emergency Medical Transport (VAN) | 1743 Plum St, Aurora, IL 60506 | 2020-01-09 |
| 1609420173 | Salma Hydari | Dentist | 1264 N Lake St., Aurora, IL 60506 | 2019-08-01 |
| 1720647092 | Tirumala Aggarwal | Dentist | Premier Dental, 1264 N Lake Street, Aurora, IL 60506 | 2019-06-11 |
| 1730644410 | Margaret Elizabeth Beallis | Counselor | 120 Gale St., Aurora, IL 60506 | 2019-02-06 |
| 1639634322 | Jordan Devera | Student in an Organized Health Care Education/Training Program | Aurora University 347 S Gladstone Ave, Pmb 729, Aurora, IL 60506 | 2019-02-06 |
| 1770077737 | Harriet L Miller | Registered Nurse | 1081 Emerald Dr, Aurora, IL 60506 | 2018-06-21 |
| 1275033516 | Lillian Antonia Villamil | Registered Nurse | 400 Mercy Lane, Aurora, IL 60506 | 2018-02-13 |
| 1689173676 | Ideal Medical Equipment and Supplies | Durable Medical Equipment & Medical Supplies | 1177 N Highland Ave Ste#204, Aurora, IL 60506 | 2018-02-06 |
| 1417465535 | Aaron Downing | Counselor | 525 N. Edgelawn Ave, Aurora, IL 60506 | 2018-01-11 |
| 1942739222 | Jessica Toma | Pharmacist | 1952 W Galena Blvd, Aurora, IL 60506 | 2017-06-08 |
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| Taxonomy Code | 273R00000X |
| Grouping | Hospital Units |
| Classification | Psychiatric Unit |
| In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning. |
| Notes: Source: (1) AHA Annual Survey p. A10 1996 AHA Guide; (2) Code of Federal Regulations #42, Section 412.27. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477592566 | Hca Healthone LLC | Psychiatric Unit | 700 S. Potomac Street, Aurora, CO 80011-6844 | 2006-06-05 |
| 1144346800 | University of Colorado Hospital Authority | Psychiatric Unit | 12605 East 16th Avenue, Aurora, CO 80045 | 2007-03-22 |
| 1639186638 | Presence Central and Suburban Hospitals Network | Psychiatric Unit | 1325 N Highland Ave, Aurora, IL 60506-1449 | 2006-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639657414 | Advocate North Side Health Network | Psychiatric Unit | 836 W Wellington Ave., Chicago, IL 60657 | 2018-08-02 |
| 1427547538 | Holy Cross Hospital | Psychiatric Unit | 2701 West 68th Street, Chicago, IL 60629 | 2018-05-03 |
| 1740570316 | Robert Young Center | Psychiatric Unit | 4200 6th Ave, Rock Island, IL 61201-2109 | 2011-04-15 |
| 1669704326 | Isaac Ray Center At Cermak | Psychiatric Unit | 3159 N Seminary #301, Chicago, IL 60657 | 2010-02-05 |
| 1316115223 | 394567 D North | Psychiatric Unit | 4200 North Oak Park Ave, Chicago, IL 60634-1417 | 2008-02-13 |
| 1508034414 | 395061 Med Eval | Psychiatric Unit | 4200 North Oak Park Avenue, Chicago, IL 60634-1417 | 2008-02-13 |
| 1952425076 | Elgin Mental Health Center William White 4585 | Psychiatric Unit | 750 S. State St., Elgin, IL 60123-7692 | 2007-03-16 |
| 1932251766 | Families and Adolescents In Recovery, Inc. | Psychiatric Unit | 2010 E Algonquin Rd, Suite # 203-207, Schaumburg, IL 60173-4185 | 2007-01-18 |
| 1003976713 | Presence Central and Suburban Hospitals Network | Psychiatric Unit | 333 N. Madison St., Joliet, IL 60435-6595 | 2006-12-11 |
| 1871678334 | Kindred Thc Chicago, LLC | Psychiatric Unit | 2544 W Montrose Ave, Chicago, IL 60618 | 2006-10-25 |
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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.