BENJAMIN ELLISON COLLIE (NPI# 1689029654) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689029654 |
| Entity Type | Individual |
| Full Name | BENJAMIN ELLISON COLLIE |
| Credential | M.D. |
| Practice Address |
2601 W Main St Carbondale IL 62901-1031 |
| Mailing Address |
Po Box 3988 Carbondale IL 62902-3988 |
| Practice Telephone | 6185495361 |
| Practice Fax Number | 6183514878 |
| Mailing Telephone | 6184575200 |
| Enumeration Date | 2016-04-27 |
| Last Update Date | 2020-10-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 036153349 | IL | Allopathic & Osteopathic Physicians |
| N | 207RH0002X |
Internal Medicine Specialization: Hospice and Palliative Medicine |
036153349 | IL | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3303 Logan Dr, Herrin, IL 629483732 | 6189988920 | 6189988923 |
| 1 Hospital Dr # Dc032.00, Columbia, MO 652121000 | 5738847060 | 5738844122 |
| Street Address |
2601 W MAIN ST |
| City | CARBONDALE |
| State | IL |
| Zip Code | 62901-1031 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548261399 | Jeffrey M Lehman | Allergy & Immunology | 2601 W Main St, Carbondale, IL 62901-1031 | 2005-08-02 |
| 1043846421 | Lindsay B Casolari | Nurse Practitioner | 2601 W Main St, Carbondale, IL 62901-1031 | 2020-03-18 |
| 1194367318 | Jessica Oakley | Nurse Practitioner | 2601 W Main St, Carbondale, IL 62901-1031 | 2019-10-09 |
| 1609424399 | Alexis Korbar | Social Worker | 2601 W Main St, Carbondale, IL 62901-1031 | 2019-08-27 |
| 1184196883 | Leslie Ann Hickman | Nurse Practitioner | 2601 W Main St, Carbondale, IL 62901-1031 | 2018-12-19 |
| 1679041685 | Kirsten Anne Beyers | Social Worker | 2601 W Main St, Carbondale, IL 62901-1031 | 2018-11-07 |
| 1457834178 | Brittany Elizabeth Pierce | Nurse Practitioner | 2601 W Main St, Carbondale, IL 62901-1031 | 2018-09-09 |
| 1306322110 | Katharine Johnson | Social Worker | 2601 W Main St, Carbondale, IL 62901-1031 | 2018-07-15 |
| 1437699147 | Gina Gladson | Nurse Practitioner | 2601 W Main St, Carbondale, IL 62901-1031 | 2017-02-28 |
| 1902349863 | Sarah Elizabeth Ruth Shannon | Nurse Practitioner | 2601 W Main St, Carbondale, IL 62901 | 2016-11-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558961268 | Gerad Aaron Harsy | Pharmacist | Walmart Pharmcy, 1450 East Main St, Carbondale, IL 62901 | 2020-10-30 |
| 1437708674 | Board of Trustees of Southern Illinois University | Clinic/Center | 300 W Oak Street, Carbondale, IL 62901 | 2019-09-10 |
| 1306317383 | Rachael O Johnson | Nurse Practitioner | 404 S. Lewis Ln, Carbondale, IL 62901 | 2018-12-17 |
| 1740795194 | Megan Marie Zimmerman | Nurse Practitioner | 1100 W Diann Ln., Carbondale, IL 62901 | 2017-12-07 |
| 1295244242 | Amy Elizabeth Prudencio | Social Worker | 1301 E. Walnut Street, Carbondale, IL 62901 | 2017-09-21 |
| 1740708171 | Theresa Aleise Goodin | Speech-Language Pathologist | 1301 East Walnut Street, Carbondale, IL 62901 | 2017-09-06 |
| 1144762527 | Kathleen Chwalisz Rigney | Psychologist | 306 West Mill Street, Neurorestorative, Carbondale, IL 62901 | 2016-11-16 |
| 1285185173 | Shawnee Health Service and Development Corp | Social Worker | 404 S. Lewis Lane, Carbondale, IL 62901 | 2016-10-17 |
| 1437605094 | Arielle Greer | Nurse's Aide | 510 E. Russell St., A, Carbondale, IL 62901 | 2016-09-01 |
| 1518413863 | Complete Family Eyecare of Carbondale, PC | Optometrist | 1241 East Walnut Street, Carbondale, IL 62901 | 2016-08-28 |
| Find all providers in zip 62901 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://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 |
|---|---|---|---|---|
| 1922443803 | Joseph S. Soliman, Md PC | Internal Medicine | 92 Salem Ave, Carbondale, PA 18407-2038 | 2013-05-06 |
| 1386965499 | Othniel Stephen Doolittle | Internal Medicine | 2250 N Illinois Ave, Carbondale, IL 62901-5612 | 2010-06-14 |
| 1306089362 | David Mitchell Marcus | Internal Medicine | 359 Crystal Canyon Dr, Carbondale, CO 81623-9151 | 2009-04-07 |
| 1184746042 | Tamrat Bekele Md | Internal Medicine | 165 Fallbrook St, Carbondale, PA 18407-1810 | 2007-04-04 |
| 1790834828 | Elbert A Fasnacht II | Internal Medicine | 721 S Lewis Ln, Carbondale, IL 62901-3344 | 2007-01-09 |
| 1962582700 | Elbert A Fasnacht II Md Ltd | Internal Medicine | 721 South Lewis Lane, Carbondale, IL 62901-3344 | 2006-10-16 |
| 1770550766 | Frank M Moro | Internal Medicine | 150 Brooklyn St, Carbondale, PA 18407-2274 | 2006-03-08 |
| 1356337133 | Kelly Colleen Higgins | Internal Medicine | 400 S Lewis Ln, Carbondale, IL 62901-3547 | 2005-09-27 |
| 1376545947 | Tamrat Bekele | Internal Medicine | 165 Fall Brook St, Carbondale, PA 18407-0000 | 2005-08-12 |
| 1114378882 | William Gray | Internal Medicine | 405 W Jackson St, Carbondale, IL 62901 | 2016-06-23 |
| Find all providers in CARBONDALE | ||||
| City | CARBONDALE |
| Zip Code | 62901 |
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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.