ILLINI MEDICAL ASSOCIATES, SC (NPI# 1821383100) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821383100 |
| Entity Type | Organization |
| Organization Name | ILLINI MEDICAL ASSOCIATES, SC |
| Practice Address |
1170 Wall St Suite 102 Jacksonville IL 62650-4053 |
| Mailing Address |
390 Maple Summit Rd Jerseyville IL 62052-2000 |
| Practice Telephone | 6184987518 |
| Practice Fax Number | 6184983052 |
| Mailing Telephone | 6184987518 |
| Mailing Fax Number | 6184983052 |
| Enumeration Date | 2011-06-14 |
| Last Update Date | 2011-09-14 |
| Authorized Official Name | SHERI A CLANTON (CBO MANAGER) |
| Authorized Official Telephone | 6184987518 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578901930 | Illini Medical Associates, Sc | Durable Medical Equipment & Medical Supplies | 390 Maple Summit Rd, Jerseyville, IL 62052-2000 | 2013-06-07 |
| 1891034294 | Illini Medical Associates, Sc | Pediatrics | 1440 W Walnut St, Ste 2a, Jacksonville, IL 62650-1143 | 2013-02-05 |
| 1023143716 | Illini Medical Associates, Sc | Family Medicine | 205 S Morse St, Roodhouse, IL 62082-1322 | 2007-02-22 |
| Street Address |
1170 WALL ST SUITE 102 |
| City | JACKSONVILLE |
| State | IL |
| Zip Code | 62650-4053 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720316011 | Braden Partners Lp | Durable Medical Equipment & Medical Supplies | 1170 Wall St, Ste 102, Jacksonville, IL 62650-4055 | 2009-11-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134768708 | Stephanie Lee Mabus | Occupational Therapy Assistant | 873 Gorve St, Jacksonville, IL 62650 | 2019-12-31 |
| 1285281071 | Sharshon Pharmacy Inc | Pharmacy | 154 W Morton Ave, Jacksonville, IL 62650 | 2019-08-26 |
| 1992275499 | Brittany Ruth Helmich | Counselor | 340 W. State St., Jacksonville, IL 62650 | 2018-11-28 |
| 1811391782 | Rodney E. Overstreet | Hearing Instrument Specialist | 1521 W. Walnut, Jacksonville, IL 62650 | 2014-10-21 |
| 1407979818 | Jan Ala | Speech-Language Pathologist | 1111 W Morton, Speechworks, Jacksonville, IL 62650 | 2007-04-09 |
| 1083787592 | Eldon G Barrowes Dds & Assoc PC | Dentist | 1515 West Walnut, Bldg #3, Jacksonville, IL 62650 | 2006-11-15 |
| 1194895979 | Joseph J Kozma | Internal Medicine | 1440 West Walnut, Jacksonville, IL 62650 | 2006-11-08 |
| 1740350529 | Susan Weller | Dentist | 1614 West Lafayette Avenue, Jackson, IL 62650 | 2006-11-08 |
| 1659467793 | Shawn M Fry | Family Medicine | 610 N. Westgate, Jacksonville, IL 62650 | 2006-10-05 |
| 1518050061 | Ward Richard Dunseth II | Nurse Anesthetist, Certified Registered | 1400 W Walnut, Jacksonville, IL 62650 | 2006-10-02 |
| Find all providers in zip 62650 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902441983 | Rebecca Taylor Dickerson | Psychiatry & Neurology | 5927 Old Timuquana Rd, Jacksonville, FL 32210-7889 | 2019-11-13 |
| 1821631045 | Rashan Jammeelah Jones | Psychiatry & Neurology | 5991 Chester Ave Ste 106, Jacksonville, FL 32217-2265 | 2019-10-21 |
| 1407320690 | Artistic Psychiatric Associates LLC | Psychiatry & Neurology | 9550 Regency Square Blvd Ste 903, Jacksonville, FL 32225-8116 | 2019-01-22 |
| 1447754080 | Julia Teytelbaum | Psychiatry & Neurology | 580 W 8th St Fl II6, Jacksonville, FL 32209-6533 | 2018-03-20 |
| 1205330933 | Luka Sogorovic | Psychiatry & Neurology | 580 W 8th St Fl 6, Jacksonville, FL 32209-6533 | 2018-03-19 |
| 1740636307 | Jonathan David Browning | Psychiatry & Neurology | 4884 Deer Creek Drive W, Jacksonville, FL 32246 | 2016-05-12 |
| 1033503503 | Victor Bryant Adriano Santos | Psychiatry & Neurology | 8823 San Jose Blvd Ste 301, Jacksonville, FL 32217-4290 | 2015-03-23 |
| 1336540830 | Angeles Alvarez-mullin | Psychiatry & Neurology | 7825 Baymeadows Way Suite 300, Florida Dept of Health, Division of Disabilities Determ, Jacksonville, FL 32256 | 2014-09-16 |
| 1639512833 | Robert D. Puder | Psychiatry & Neurology | 1250 Western Blvd Ste L2, #292, Jacksonville, NC 28546-6755 | 2013-04-08 |
| 1043586746 | Henry Lepely Md Pa | Psychiatry & Neurology | 4131 University Blvd S Ste 7, Jacksonville, FL 32216-4346 | 2012-03-27 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 62650 |
Please comment or provide details below to improve the information on ILLINI MEDICAL ASSOCIATES, SC.
| 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.