BRIAN BOSTWICK (NPI# 1891768636) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891768636 |
| Entity Type | Individual |
| Full Name | BRIAN BOSTWICK |
| Credential | MD |
| Practice Address |
301 N 8th St Pav 4a Springfield IL 62702 |
| Mailing Address |
530 Ne Glen Oak Ave Peoria IL 61637-0001 |
| Practice Telephone | 2175458000 |
| Practice Fax Number | 2175452303 |
| Mailing Telephone | 3096553292 |
| Mailing Fax Number | 3096557732 |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2020-10-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 036106503 | IL | Allopathic & Osteopathic Physicians |
| Y | 208000000X | Pediatrics | 036106503 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BCBS | 07215036 | 01 |
| IL | 036106503 | 05 | |
| IL | JOHN DEERE | IL0104 | 01 |
| Street Address |
301 N 8TH ST PAV 4A |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578565420 | Samuel Poriza Au | Radiology | 301 N 8th St, Springfield, IL 62701-1041 | 2005-08-11 |
| 1073148375 | Ashley Kirkpatrick | Nurse Practitioner | 301 N 8th St, Springfield, IL 62701-1041 | 2020-03-06 |
| 1699260299 | Eman Mosleh | Pediatrics | 301 N 8th St, Springfield, IL 62701-1041 | 2018-06-26 |
| 1508370719 | Linsey Meloche | Nurse Practitioner | 301 N 8th St, Springfield, IL 62701-1041 | 2017-11-27 |
| 1649789736 | Nichole Kristine Chatham | Occupational Therapist | 301 N 8th St, Springfield, IL 62701-1041 | 2017-09-21 |
| 1174075147 | Loralee Donnelly | Nurse Practitioner | 301 N 8th St, Springfield, IL 62701 | 2016-10-26 |
| 1740639533 | Matthew Leland Davis | Urology | 301 N 8th St, Springfield, IL 62701-1041 | 2016-06-13 |
| 1578910741 | Bradley Christopher Holland | Urology | 301 N 8th St, 4b143c, Springfield, IL 62701-1041 | 2016-05-18 |
| 1295182467 | Meredith Volle | Pediatrics | 301 N 8th St, 4a, Springfield, IL 62701-1041 | 2016-05-18 |
| 1205299542 | Rebecca S. Vanmeter | Nurse Practitioner | 301 N 8th St, Springfield, IL 62701-1041 | 2016-04-04 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457866519 | Mohammad Jamal Uddin Ansari | Internal Medicine | 751 N Rutledge St Ste 400, Springfield, IL 62702 | 2017-12-11 |
| 1588105811 | Mickey Graphia | Surgery | 701 N 1st St # D346, Springfield, IL 62702 | 2017-03-20 |
| 1376908913 | Abdul Hannan | Internal Medicine | 315 W Carpenter St # B, Springfield, IL 62702 | 2015-12-28 |
| 1871986414 | Rachel Hoselton | Nurse Practitioner | 400 N 9th St Fl 4, Springfield, IL 62702 | 2015-03-06 |
| 1548697774 | Alyssa Wilson | Behavioral Analyst | 232 Bruns Lane, One Sparcenter Plaza, Springfield, IL 62702 | 2013-10-02 |
| 1174965446 | Amy Wilson | Speech-Language Pathologist | 2120 West Washington Street, Springfield, IL 62702 | 2013-07-26 |
| 1275898116 | Pele Boutrous Dina | Pediatrics | 415 N 9th St # 4w16, Springfield, IL 62702 | 2012-07-06 |
| 1427327733 | Brook D Croke | Genetic Counselor, MS | 400 N. 9th Street, 3rd Floor Clinic B, Springfield, IL 62702 | 2011-12-16 |
| 1629352604 | Renae M Sanchez | Pharmacist | 3216 East Clearlake Ave, Springfield, IL 62702 | 2011-10-07 |
| 1982915302 | William Leland Zelkovich | Radiology | 701 N 1st, Springfield, IL 62702 | 2010-06-30 |
| Find all providers in zip 62702 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467074492 | Kinnera Are | Pediatrics | 400 N 9th St Ste 4a, Springfield, IL 62702-5310 | 2020-05-13 |
| 1306208368 | Mckenzie Smith | Pediatrics | 2115 S Fremont Ave Ste 2900, Springfield, MO 65804-2233 | 2016-03-28 |
| 1790181402 | Sonam Verma | Pediatrics | 400 N 9th St # 4a, Springfield, IL 62702-5310 | 2014-11-06 |
| 1619382132 | Eric D Mcfeely | Pediatrics | 280 Chestnut Street, 2nd Floor, Springfield, MA 01199-1001 | 2014-06-23 |
| 1073923231 | Charlotte Mcknight | Pediatrics | 6120 Brandon Ave Ste 308, Springfield, VA 22150-2504 | 2014-04-28 |
| 1336437078 | Rashmi Jain | Pediatrics | 1965 S Fremont Ave Ste 260, Springfield, MO 65804-2257 | 2011-07-15 |
| 1861785958 | Sienna Vorono Winer | Pediatrics | 6501 Loisdale Ct., Springfield, VA 22150 | 2011-05-23 |
| 1649581570 | Kendra Suzanne Woods | Pediatrics | 415 N 9th St Ste 2w126, Springfield, IL 62702-5303 | 2010-06-25 |
| 1518117159 | Jyoti Assudani | Pediatrics | 301 N 8th Street, Springfield, IL 62701 | 2008-09-19 |
| 1417105024 | Stephen Edward Saunders | Pediatrics | 5 Orchard Ln, Springfield, IL 62712-8911 | 2008-09-08 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62702 |
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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.