JANETTE S MARCIANO (NPI# 1639444110) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639444110 |
| Entity Type | Individual |
| Full Name | JANETTE S MARCIANO |
| Other Name | JANETTE S ELLIS |
| Credential | PA-C |
| Practice Address |
200 Dettro Dr Mattoon IL 61938-9003 |
| Mailing Address |
1005 Health Center Dr Ste 201 Mattoon IL 61938-4693 |
| Practice Telephone | 2172383000 |
| Practice Fax Number | 2172383008 |
| Mailing Telephone | 2172386055 |
| Enumeration Date | 2012-03-15 |
| Last Update Date | 2018-09-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 085-004294 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1100 Tuscola Blvd, Tuscola, IL 619532065 | 2172534764 | 2172534886 |
| 2040 Lincoln Ave Ste 100, Charleston, IL 619203197 | 2173452030 | 2173452045 |
| Street Address |
200 DETTRO DR |
| City | MATTOON |
| State | IL |
| Zip Code | 61938-9003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720165103 | Bonnie Jean Coburn | Nurse Practitioner | 200 Dettro Dr, Mattoon, IL 61938-9003 | 2006-11-01 |
| 1124586565 | Ashley Adams | Nurse Practitioner | 200 Dettro Dr, Mattoon, IL 61938-9003 | 2019-03-05 |
| 1710433529 | Leah Teichmiller | Physician Assistant | 200 Dettro Dr, Mattoon, IL 61938 | 2016-08-31 |
| 1104218247 | Amanda Stroud | Nurse Practitioner | 200 Dettro Dr, Mattoon, IL 61938 | 2015-02-26 |
| 1568747822 | Jessica Lynn Mathenia | Physician Assistant | 200 Dettro Dr, Mattoon, IL 61938-9003 | 2011-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043831134 | St Anthony's Memorial Hospital of The Hospital Sisters of The Third Or | Clinic/Center | 101 Coles Centre Pkwy, Ste 101, Mattoon, IL 61938 | 2020-04-30 |
| 1215436449 | Sarah Bush Lincoln Health Center | Durable Medical Equipment & Medical Supplies | 300 Coles Centre Pkwy, Mattoon, IL 61938 | 2018-02-02 |
| 1841707726 | Mattoon Chiropractic LLC | Chiropractor | 905 Remington Rd, Mattoon, IL 61938 | 2018-01-02 |
| 1164892758 | Dr. Charles L. Schnibben Ltd. | Dentist | 1502 Lakeland Blvd, Mattoon, IL 61938 | 2015-09-25 |
| 1982000139 | Judy A. Clark | Hearing Instrument Specialist | 1302 Charleston Avenue, Audibel Hearing Aids, Mattoon, IL 61938 | 2014-11-17 |
| 1023419884 | Christopher Steven Lillie | Physician Assistant | 200 Richmond Ave East, Family Medical Center, Mattoon, IL 61938 | 2014-09-11 |
| 1295055168 | Jennifer Harp | Mechanotherapist | 232 Richmond Ave East, Mattoon, IL 61938 | 2010-06-02 |
| 1447482682 | Gene Clark Hearing Aid Service | Hearing Aid Equipment | 208 Wabash, Mattoon, IL 61938 | 2009-08-21 |
| 1326229774 | Central Illinois Family Health Center | Nurse Practitioner | 10555 East County Rd 800 North, Mattoon, IL 61938 | 2007-11-14 |
| 1568656445 | Bernie Ranchero | Family Medicine | 1004 Health Center Dr Ste 210, Mattoon, IL 61938 | 2007-09-04 |
| Find all providers in zip 61938 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023419884 | Christopher Steven Lillie | Physician Assistant | 200 Richmond Ave East, Family Medical Center, Mattoon, IL 61938 | 2014-09-11 |
| 1285910059 | Jeremy Mathenia | Physician Assistant | 200 Richmond Ave E Ste 2, Mattoon, IL 61938-4652 | 2011-10-25 |
| 1184733743 | Jolena M Martin | Physician Assistant | 144 Dettro Dr, Mattoon, IL 61938-9012 | 2006-08-29 |
| 1710093018 | Stacey Harminson | Physician Assistant | 1005 Health Center Dr Ste 104, Mattoon, IL 61938-4693 | 2006-08-21 |
| 1609863620 | Hong Holly Zhang | Physician Assistant | 2512 Hurst Dr., Ste 120, Mattoon, IL 61938-9388 | 2005-10-04 |
| 1497305908 | Dana Sautter | Physician Assistant | 1000 Health Center Dr, Mattoon, IL 61938-4644 | 2019-09-17 |
| 1811464381 | Timothy B O'leary | Physician Assistant | 1000 Health Center Dr, Mattoon, IL 61938-9261 | 2018-11-01 |
| 1689123010 | Amanda N Mccormick | Physician Assistant | 1000 Health Center Dr, Mattoon, IL 61938-9261 | 2016-09-27 |
| 1710433529 | Leah Teichmiller | Physician Assistant | 200 Dettro Dr, Mattoon, IL 61938 | 2016-08-31 |
| 1871902411 | Margaret M. Byrne | Physician Assistant | 1000 Health Center Dr, Mattoon, IL 61938-9253 | 2014-08-07 |
| Find all providers in MATTOON | ||||
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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.