ST JOSEPH MEDICAL CENTER (NPI# 1881782878) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881782878 |
| Entity Type | Organization |
| Organization Name | ST JOSEPH MEDICAL CENTER |
| Other Organization Name | HEARTCARE MIDWEST |
| Practice Address |
1505 Eastland Dr Suite 110 Bloomington IL 61701-3534 |
| Practice Telephone | 3096639800 |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2007-08-27 |
| Authorized Official Name | KENNETH J. NATZKE (CEO) |
| Authorized Official Telephone | 3096655780 |
| Is Organization Subpart | Y |
| Parent Organization Name | OSF HEALTHCARE SYSTEM |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS BLUE SHIELD | 057-32087 | 01 |
| Other Name | Type Code |
|---|---|
| HeartCare Midwest | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851330203 | St Joseph Medical Center | Home Health | 211 Landmark Dr, Suite D3, Normal, IL 61761-2160 | 2006-06-04 |
| 1871547414 | St Joseph Medical Center | Internal Medicine | 302 Saint Joseph Dr, Bloomington, IL 61701-3506 | 2006-05-19 |
| 1679012710 | St Joseph Medical Center | General Acute Care Hospital | 8441 State Highway 47, Suite 4300, Bryan, TX 77807-3207 | 2017-02-22 |
| 1336465004 | St Joseph Medical Center | General Acute Care Hospital | 1717 S J St, Tacoma, WA 98405-4933 | 2010-04-20 |
| 1174758346 | St Joseph Medical Center | Radiology | 407 E Vernon Ave, Normal, IL 61761-3813 | 2009-05-18 |
| 1902066400 | St Joseph Medical Center | Preventive Medicine | 1505 Eastland Dr, Suite 1000, Bloomington, IL 61701-3534 | 2008-06-10 |
| 1659552859 | St Joseph Medical Center | Emergency Medicine | 2200 E Washington St, Bloomington, IL 61701-4364 | 2007-11-16 |
| 1184732851 | St Joseph Medical Center | General Acute Care Hospital | 2200 E Washington St, Bloomington, IL 61701-4364 | 2006-08-25 |
| 1932148236 | St Joseph Medical Center | Skilled Nursing Facility | 2200 E Washington St, Bloomington, IL 61701-4364 | 2006-06-05 |
| 1619916806 | St Joseph Medical Center | General Acute Care Hospital | 2200 E Washington St, Bloomington, IL 61701-4364 | 2006-06-05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ST JOSEPH MEDICAL CENTER | 1717 S J St, Tacoma, WA 98405-4933 |
| Street Address |
1505 EASTLAND DR SUITE 110 |
| City | BLOOMINGTON |
| State | IL |
| Zip Code | 61701-3534 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336142017 | Yogesh K Agarwal | Internal Medicine | 1505 Eastland Dr, Ste 330, Bloomington, IL 61701-3534 | 2005-05-24 |
| 1073082384 | Caroline J Turner | Nurse Practitioner | 1505 Eastland Dr, Bloomington, IL 61701-3534 | 2018-11-15 |
| 1548755366 | Sunanda R Kale | Nurse Practitioner | 1505 Eastland Dr, Bloomington, IL 61701-3534 | 2018-06-25 |
| 1790294403 | Sarah Kneip | Nurse Practitioner | 1505 Eastland Dr, Bloomington, IL 61701-3534 | 2017-09-26 |
| 1760909626 | Hannah K Corley | Nurse Practitioner | 1505 Eastland Dr, Bloomington, IL 61701-3534 | 2017-08-23 |
| 1467827592 | Kelly Karr | Registered Nurse | 1505 Eastland Dr, Bloomington, IL 61701-3534 | 2015-12-01 |
| 1205219607 | Michele Krieger-johnsen | Nurse Practitioner | 1505 Eastland Dr, Bloomington, IL 61701-7905 | 2015-07-02 |
| 1326420563 | Fresenius Medical Care Normal, LLC | Clinic/Center | 1505 Eastland Dr, Medical Plaza Lower Level, Bloomington, IL 61701-3534 | 2015-06-24 |
| 1588068803 | Allison Vogel | Physician Assistant | 1505 Eastland Dr, Bloomington, IL 61701-3534 | 2014-10-15 |
| 1578964987 | Kristin N Wilkins | Clinical Nurse Specialist | 1505 Eastland Dr, Suite 320, Bloomington, IL 61701-3534 | 2014-09-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770140964 | County of Mclean | Community/Behavioral Health | 200 W Front St, 1st Floor Sw, C/o 200 W Front St, Suite 400f, Bloomington, IL 61701 | 2019-05-22 |
| 1023525292 | Karli Johnson | Counselor | 200 W Monroe St Ste C7, Bloomington, IL 61701 | 2018-01-09 |
| 1487172409 | Melody Ann Bauman | Physician Assistant | 1505 Eastland Dr, Osf Critical Cane, Pulmonary, Sleep M, Bloomington, IL 61701 | 2017-08-30 |
| 1215396288 | Heidi Larsen | Social Worker | 902 S East St, Bloomington, IL 61701 | 2016-02-18 |
| 1558735126 | Andrea E. Andrews Counseling LLC | Counselor | 200 W. Monroe St., Ste 302 C, Bloomington, IL 61701 | 2015-11-19 |
| 1174924856 | Carole Hahn | Dietitian, Registered | 1406 Forrest St, Bloomington, IL 61701 | 2014-09-12 |
| 1558786392 | Valerie Colleen Parker | Counselor | 109 W. Mulberry St., Bloomington, IL 61701 | 2014-03-04 |
| 1124459219 | Matilde Francois | Surgery | 1505 Eastland Dr Ste 2300, Bloomington, IL 61701 | 2013-11-27 |
| 1922435114 | Smitha H Shivaprasad | Pharmacist | 2611 East Oakland Avenue, Bloomington, IL 61701 | 2013-10-02 |
| 1295161941 | Ashvin Patel | Obstetrics & Gynecology | 31 Country Club Pl, Bloomington, IL 61701 | 2013-09-25 |
| Find all providers in zip 61701 | ||||
| Taxonomy Code | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023189677 | Kevin Edward Zawacki | Internal Medicine | 1312 W. Arch Haven Avenue, Bloomington, IN 47403 | 2006-11-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164984514 | Cil Care of Il II, LLC | Internal Medicine | 1900 E Golf Rd Ste 950, Schaumburg, IL 60173-5034 | 2019-04-04 |
| 1467950733 | Coordinated Health of Il, LLC | Internal Medicine | 1900 E Golf Rd Ste 950c, Schaumburg, IL 60173-5834 | 2018-01-31 |
| 1740728039 | Jenna Schrage | Internal Medicine | 317 N 5th St, Springfield, IL 62701-1003 | 2017-02-07 |
| 1417373010 | Hashim Gazi | Internal Medicine | 3331 West Deyoung, Suite 100, Marion, IL 62959 | 2014-03-07 |
| 1992041644 | Daniel Brent Nelson | Internal Medicine | 3810 Farhills Dr, Champaign, IL 61822-9321 | 2012-12-28 |
| 1801184767 | Surya Teja Chaturvedula | Internal Medicine | 5409 N Knoxville Ave Ste 207, Peoria, IL 61614-5069 | 2011-07-13 |
| 1841583952 | C Dean Katsamakis Do Facc Sc | Internal Medicine | 240 Waukegan Rd, Glenview, IL 60025-5159 | 2011-05-23 |
| 1154550119 | Elliott M Groves | Internal Medicine | 840 S Wood St Ste Smc715, Chicago, IL 60612-4325 | 2009-07-10 |
| 1841484813 | Elsayed Mohamed | Internal Medicine | 804 E Woodfield Rd Ste 300, Schaumburg, IL 60173-4776 | 2007-08-31 |
| 1952513335 | Muhammad Sikander Akbar | Internal Medicine | 6300 N Lincoln Ave, Chicago, IL 60659-1204 | 2007-05-05 |
| Find all providers with the same taxonomy | ||||
| City | BLOOMINGTON |
| Zip Code | 61701 |
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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.