EFFINGHAM UROLOGY ASSOCIATES,S.C. (NPI# 1902911431) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902911431 |
| Entity Type | Organization |
| Organization Name | EFFINGHAM UROLOGY ASSOCIATES,S.C. |
| Practice Address |
414 W Virginia Ave Effingham IL 62401-2258 |
| Mailing Address |
414 W Virginia Ave P O Box 1169 Effingham IL 62401-2258 |
| Practice Telephone | 2173429738 |
| Practice Fax Number | 2173429806 |
| Mailing Telephone | 2173429738 |
| Mailing Fax Number | 2173429806 |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2008-05-19 |
| Authorized Official Name | DR. PERNANKEL D L NAYAK (OWNER) |
| Authorized Official Telephone | 2173429738 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
042003881 | IL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BCBS | 0002500053 | 01 |
| IL | RAILROAD MEDICARE | CC9824 | 01 |
| Street Address |
414 W VIRGINIA AVE |
| City | EFFINGHAM |
| State | IL |
| Zip Code | 62401-2258 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144285826 | David W Mcnichols | Urology | 414 W Virginia Ave, Effingham, IL 62401-2258 | 2006-04-18 |
| 1437506722 | Alicia Davis | Nurse Practitioner | 414 W Virginia Ave, Effingham, IL 62401-2258 | 2016-05-17 |
| 1649586819 | Bernard H Habing | Nurse Practitioner | 414 W Virginia Ave, Effingham, IL 62401-2258 | 2010-08-26 |
| 1841398468 | Angie D Yocom | Nurse Practitioner | 414 W Virginia Ave, Effingham, IL 62401-2258 | 2006-09-20 |
| 1114982154 | Pernankel D Nayak | Urology | 414 W Virginia Ave, Effingham, IL 62401-2258 | 2006-04-20 |
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|---|---|---|---|---|
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| 1033632187 | Diel Counseling Inc. | Counselor | 444 S. Willow #7, Effingham, IL 62401 | 2017-07-20 |
| 1770930968 | Community Support Systems | Intermediate Care Facility, Mentally Retarded | 2311 Veterans Drive, Effingham, IL 62401 | 2016-05-18 |
| 1194107102 | Radhika Annam | Internal Medicine | 500 N. Maple St., Joslin Diabetes Center Affiliate At Hshs Medical Group, Effingham, IL 62401 | 2015-06-25 |
| 1912334558 | Ruben Boyajian, Md | Surgery | 904 Medical Park Drive, Suite 2, Effingham, IL 62401 | 2013-09-27 |
| 1427483502 | Daniel E Czajkowski | Physical Therapist | 2611 S Banker St, Effingham, Il, Effingham, IL 62401 | 2013-09-09 |
| 1093140501 | Lifetime Dental Care of Maryland, Badger, P.C. | Dentist | 1200 Network Centre Drive, Suite #2, Effingham, IL 62401 | 2013-09-04 |
| 1689926487 | Wellness Loft Inc. | Counselor | 408 South 4th St., Effingham, IL 62401 | 2012-10-04 |
| 1598011470 | Patricia R. Diel | Social Worker | 444 S. Willow, Suite 7, Effingham, IL 62401 | 2012-07-30 |
| Find all providers in zip 62401 | ||||
| Taxonomy Code | 261QH0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Health Service |
| Definition to come... |
| Notes: [7/1/2006: modified title] |
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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.