DWIGHT O'DELL, M.D., LTD. (NPI# 1639271513) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639271513 |
| Entity Type | Organization |
| Organization Name | DWIGHT O'DELL, M.D., LTD. |
| Practice Address |
4550 Memorial Dr Suite 200 Belleville IL 62226-5359 |
| Practice Telephone | 6182335998 |
| Practice Fax Number | 6182336001 |
| Mailing Telephone | 6182335998 |
| Mailing Fax Number | 6182336001 |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2007-10-09 |
| Authorized Official Name | DR. DWIGHT WILLIAM O'DELL (PRESIDENT) |
| Authorized Official Telephone | 6182335998 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
IL | Allopathic & Osteopathic Physicians |
| Street Address |
4550 MEMORIAL DR SUITE 200 |
| City | BELLEVILLE |
| State | IL |
| Zip Code | 62226-5359 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427055961 | Lawrence Mcclinton | Physician Assistant | 4550 Memorial Dr, Ste. 280, Belleville, IL 62226-5372 | 2005-06-30 |
| 1902273717 | Tammi Lynn Jones | Nurse Practitioner | 4550 Memorial Dr, Suite 360, Belleville, IL 62226-5372 | 2015-08-27 |
| 1235474057 | Memorial Medical Group, LLC | Anesthesiology | 4550 Memorial Dr, Ste. 340, Belleville, IL 62226-5372 | 2012-12-05 |
| 1013265248 | Deanna L. Rodenberg | Registered Nurse | 4550 Memorial Dr, Ste. 340, Belleville, IL 62226-5372 | 2012-08-20 |
| 1699061259 | Oa Associated LLC | Specialist/Technologist | 4550 Memorial Dr, Moc-1, Suite G-100, Belleville, IL 62226-5372 | 2011-06-22 |
| 1619260932 | Dori Hunt | Nurse Practitioner | 4550 Memorial Dr, Ste. 340, Belleville, IL 62226-5372 | 2011-05-19 |
| 1821302118 | Pc Associates, LLC | Hospitalist | 4550 Memorial Dr, Suite 340, Belleville, IL 62226-5372 | 2010-07-29 |
| 1386958668 | Pc Associates, LLC | Family Medicine | 4550 Memorial Dr, Ste 180, Belleville, IL 62226-5372 | 2010-07-29 |
| 1376857656 | Ca Group, LLC | Internal Medicine | 4550 Memorial Dr, Ste 310, Belleville, IL 62226-5372 | 2010-07-29 |
| 1649584921 | Ca Group LLC | Internal Medicine | 4550 Memorial Dr, Suite 320, Belleville, IL 62226-5372 | 2010-07-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639778160 | Roxanna Lee Gunnels | Nurse Practitioner | 1 Bronze Pointe Plaza Suite 1a, Swansea, IL 62226 | 2020-10-26 |
| 1053969790 | Consistent Medical Transportation | Driver | 2012 N 17th St, Swansea, IL 62226 | 2019-08-27 |
| 1497314371 | Medi-plex Hospice of Illinois, LLC | Registered Nurse | 8 Park Place, Suite #3, Swansea, IL 62226 | 2019-06-13 |
| 1336617364 | Nicole Renee Schmidt | Speech-Language Pathologist | 150 N 27th St., Belleville, IL 62226 | 2018-11-07 |
| 1295258903 | Catherine Espino | Pharmacist | 11 Chambers Blvd, Swansea, IL 62226 | 2017-07-25 |
| 1366806838 | Kiley Faires | Nurse Practitioner | 4600 Memorial Drive Ste 360, Belleville, IL 62226 | 2016-04-11 |
| 1760857585 | Mvp Transportation | Non-emergency Medical Transport (VAN) | 1229 N 17th Street, Number 23, Belleville, IL 62226 | 2015-12-04 |
| 1275952566 | Aisha Danyale Franklin | Internal Medicine | 4261 Woodfield Pl, Belleville, IL 62226 | 2014-04-15 |
| 1396168332 | Jayne E. Ninness | Physical Therapy Assistant | 4500 Memorial Dr., Memorial Hospital, Belleville, IL 62226 | 2014-01-28 |
| 1053758193 | Gateway Foundation, Inc. | Clinic/Center | 1 Bronze Point, Suite 1, Swansea, IL 62226 | 2013-05-30 |
| Find all providers in zip 62226 | ||||
| Taxonomy Code | 207VG0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Gynecology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629386586 | Ob Practice, LLC | Obstetrics & Gynecology | 4600 Memorial Drive, Ste. 400, Belleville, IL 62226 | 2010-09-14 |
| 1871779579 | Gerard R Cicalese | Obstetrics & Gynecology | 330 Washington Ave, Belleville, NJ 07109-5218 | 2008-01-14 |
| 1508953746 | Southern Illinois Physician Services, PC | Obstetrics & Gynecology | 4600 Memorial Drive, Suite 340, Belleville, IL 62226 | 2006-10-09 |
| 1477592194 | Stephen V Mueller | Obstetrics & Gynecology | 180 S 3rd St, Suite 200, Belleville, IL 62220-1952 | 2006-06-06 |
| 1194770933 | Dwight William O'dell | Obstetrics & Gynecology | 4550 Memorial Dr, Ste 200, Belleville, IL 62226-5359 | 2006-05-23 |
| 1063484996 | Jahir C Sama | Obstetrics & Gynecology | 5 Franklin Ave, Belleville, NJ 07109-3532 | 2006-02-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477167112 | Omnidoc Health Inc | Obstetrics & Gynecology | 351 Greenleaf St Ste E, Park City, IL 60085-5701 | 2020-09-01 |
| 1396142857 | Illinois Institute of Gynecology and Advanced Pelvic Surgery, Sc | Obstetrics & Gynecology | 1351 W Belmont Ave, Chicago, IL 60657-7195 | 2014-11-28 |
| 1902171325 | Womens Health Institute of Illinois Ltd | Obstetrics & Gynecology | 10762 W 167th St, Orland Park, IL 60467-5434 | 2012-03-19 |
| 1609148303 | Archimedes Sison Diamante | Obstetrics & Gynecology | 949 N Euclid Ave, Oak Park, IL 60302-1319 | 2012-01-27 |
| 1376821025 | Prairieview Gyn LLC | Obstetrics & Gynecology | 3929 Morgan Trl, Bourbonnais, IL 60914-4738 | 2011-07-29 |
| 1932493236 | Integrative Medical Options LLC | Obstetrics & Gynecology | 305 N. 2nd St, St. Charles, IL 60174 | 2011-06-03 |
| 1477715142 | Michel Medical Assoc., S.c. | Obstetrics & Gynecology | 2600 S Michigan Ave Ste 314, Chicago, IL 60616-2860 | 2008-06-25 |
| 1477727550 | All Women's Medical Center | Obstetrics & Gynecology | 3140 W Irving Prk. Rd, Chicago, IL 60618 | 2008-04-18 |
| 1053581371 | S L Fuentes Md D M Milanes Md Sc | Obstetrics & Gynecology | 107 Center St, Grayslake, IL 60030-1532 | 2008-03-03 |
| 1477731784 | Marianna Vardaka Md Inc | Obstetrics & Gynecology | 1087 Solutions Ctr, Chicago, IL 60677-1000 | 2008-02-08 |
| Find all providers with the same taxonomy | ||||
| City | BELLEVILLE |
| Zip Code | 62226 |
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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.