DHANASARN MONGKOLSMAI (NPI# 1669756060) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1669756060 |
Entity Type | Individual |
Full Name | DHANASARN MONGKOLSMAI |
Credential | M.D. |
Practice Address |
2206 Berrywood Ln Bloomington IL 61704-2448 |
Practice Telephone | 3096622032 |
Mailing Telephone | 3096622032 |
Enumeration Date | 2011-10-04 |
Last Update Date | 2011-10-04 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207R00000X | Internal Medicine | 036059806 | IL | Allopathic & Osteopathic Physicians |
Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
036059806 | IL | Allopathic & Osteopathic Physicians |
Street Address |
2206 BERRYWOOD LN |
City | BLOOMINGTON |
State | IL |
Zip Code | 61704-2448 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194009415 | Chalermlarp Mongkolsmai | Pediatrics | 2206 Berrywood Ln, Bloomington, IL 61704-2448 | 2011-10-05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518430859 | Visionpoint Eye Center LLC | Optometrist | 1107 Airport Road, Bloomington, IL 61704 | 2019-01-09 |
1922588235 | Geethu Sabu Makil | Speech-Language Pathologist | 1039 Blueheron Way, Apt#3, Bloomington, IL 61704 | 2018-08-16 |
1629596812 | Mental Wellness Center Inc | Counselor | 202 N Prospect Rd Ste 207, Bloomington, IL 61704 | 2017-09-07 |
1649798513 | Sarah Goodner | Psychologist | 1704 Royal Pointe Drive, Bloomington, IL 61704 | 2017-08-31 |
1346760253 | Elizabeth Devlin | Nurse Practitioner | 25 Long Cove Ct, Bloomington, IL 61704 | 2017-06-21 |
1396107918 | Darla Schwertfeger | Specialist/Technologist, Other | 2104 Hedgewood Dr, Bloomington, IL 61704 | 2016-03-23 |
1740662949 | Oncology Hematology Associates of Central Illinois | Pharmacy | 3105 Magory Drive, Bloomington, IL 61704 | 2015-06-24 |
1821478967 | Kelly R Andrews | Massage Therapist | 4101 Wicker Rd, Bloomington, IL 61704 | 2015-06-03 |
1235522582 | All Ways Caring Services, Inc. | In Home Supportive Care | 209 S Prospect Rd, Suite 3e, Bloomington, IL 61704 | 2015-03-11 |
1396093977 | Bhawna Gupta | Physical Therapist | 2200 East Washington Street, Bloomington, IL 61704 | 2012-08-29 |
Find all providers in zip 61704 |
Taxonomy Code | 207RC0000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Cardiovascular Disease |
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740367895 | William V Novak | Internal Medicine | 1505 Eastland Dr., Bloomington, IL 61701 | 2006-11-01 |
1477523645 | Scott E. Mattson | Internal Medicine | 1312 W Arch Haven Ave Ste A, Bloomington, IN 47403-2088 | 2006-01-23 |
1104821974 | Jennifer Petersen-goldspiel | Internal Medicine | 1312 W. Arch Haven Avenue, Bloomington, IN 47403 | 2005-06-16 |
1336142017 | Yogesh K Agarwal | Internal Medicine | 1505 Eastland Dr, Ste 330, Bloomington, IL 61701-3534 | 2005-05-24 |
1184980880 | Saki Miwa | Internal Medicine | 1312 W Arch Haven Ave Ste A, Bloomington, IN 47403-2088 | 2012-04-06 |
1124221684 | Kevin F Sumption | Internal Medicine | 1312 W Arch Haven Ave Ste A, Bloomington, IN 47403-2088 | 2007-06-11 |
1558423806 | Bloomington Cardiology PC | Internal Medicine | 822 W 1st St, Suite 7, Bloomington, IN 47403 | 2006-12-14 |
1780796417 | Andrew Dundee Ferguson | Internal Medicine | 1312 W. Arch Haven Avenue, Suite A, Bloomington, IN 47403 | 2006-08-31 |
1831110352 | Louis J Calli Jr. | Internal Medicine | 550 S Landmark Ave, Bloomington, IN 47403-3239 | 2006-07-21 |
1962450734 | Illinois Cardiovascular & Thoracic Surgery, Ltd | Internal Medicine | 1505 Eastland Dr, Suite 210, Bloomington, IL 61701-7906 | 2006-05-04 |
Find all providers in BLOOMINGTON |
City | BLOOMINGTON |
Zip Code | 61704 |
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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.