FERRELL HOSPITAL FAMILY PRACTICE CLINIC (NPI# 1922312396) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922312396 |
| Entity Type | Organization |
| Organization Name | FERRELL HOSPITAL FAMILY PRACTICE CLINIC |
| Practice Address |
1201 Pine St Eldorado IL 62930-1634 |
| Practice Telephone | 6182979665 |
| Practice Fax Number | 6182979664 |
| Mailing Telephone | 6182979665 |
| Mailing Fax Number | 6182979664 |
| Enumeration Date | 2010-07-28 |
| Last Update Date | 2013-12-04 |
| Authorized Official Name | MR. KEITH BROACH (CEO) |
| Authorized Official Telephone | 6182733361 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Street Address |
1201 PINE ST |
| City | ELDORADO |
| State | IL |
| Zip Code | 62930-1634 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508843996 | Ahmed Ali Tariq | Internal Medicine | 1201 Pine St, Eldorado, IL 62930-1634 | 2005-12-27 |
| 1750917647 | Betty J German | Social Worker | 1201 Pine St, Eldorado, IL 62930-1634 | 2020-03-23 |
| 1447796289 | Crossroads Emergency Physicians LLP | Emergency Medicine | 1201 Pine St, Eldorado, IL 62930-1634 | 2017-01-18 |
| 1033651559 | Christine Lucille Raben | Social Worker | 1201 Pine St, Eldorado, IL 62930-1634 | 2016-11-15 |
| 1659756062 | Melissa J Obert | Occupational Therapist | 1201 Pine St, Eldorado, IL 62930 | 2015-07-27 |
| 1649602368 | Core Physician Resources PC | Emergency Medicine | 1201 Pine St, Eldorado, IL 62930-1634 | 2013-08-05 |
| 1639328479 | Terri S Young | Physical Therapist | 1201 Pine St, Eldorado, IL 62930-1634 | 2008-09-17 |
| 1801044417 | Bruce H Bradley | Occupational Therapist | 1201 Pine St, Eldorado, IL 62930-1634 | 2008-09-08 |
| 1780883843 | Nathan Oldham | Family Medicine | 1201 Pine St, Eldorado, IL 62930-1634 | 2007-07-17 |
| 1477761781 | Lauren Meredith Sanders | Counselor | 1201 Pine St, Eldorado, IL 62930-1634 | 2007-05-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164951802 | Jeanette Long X | Licensed Practical Nurse | 70 Alexander St, Eldorado, IL 62930 | 2017-06-07 |
| 1720510514 | Mckayla Addison Wren | Counselor | 1412 Us. 45n, Eldorado, IL 62930 | 2017-03-30 |
| 1407394901 | Melody Jo Smith | Licensed Practical Nurse | 2260 Raleigh Road, Eldorado, IL 62930 | 2017-02-03 |
| 1205250412 | Becks Long Term Care Pharmacy Inc | Pharmacy | 1413 Locust Street, Eldorado, IL 62930 | 2014-02-07 |
| 1346559283 | Danny Ray Phillips | Pharmacist | 1021 Us Hwy 45 North, Eldorado, IL 62930 | 2010-09-27 |
| 1447434477 | Elana Ruth Floyd-kennett | Social Worker | 1007 Route 45, Eldorado, IL 62930 | 2007-12-27 |
| 1417150376 | Luke Tyler Hall | Family Medicine | 1407 Locust St, Eldorado, IL 62930 | 2007-06-07 |
| 1134320039 | Eldorado Community Unit School District #4 | Local Education Agency (LEA) | 1040 Washington, Eldorado, IL 62930 | 2007-05-29 |
| 1013071026 | Marion Eye Centers Ltd. | Durable Medical Equipment & Medical Supplies | 1204 U.S. 45 N., Eldorado, IL 62930 | 2006-12-21 |
| 1467536557 | Debra Dian Rumsey | Licensed Practical Nurse | 607 4th Street, Eldorado Rural Health Clinic, Eldorado, IL 62930 | 2006-10-25 |
| Find all providers in zip 62930 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306074042 | Ferrell Hospital Family Practice | Clinic/Center | 1306 Maple St, Eldorado, IL 62930-1662 | 2009-07-01 |
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| 1013514298 | Mount Sinai Community Foundation Dba Sinai Medical Group | Clinic/Center | 1500 S Fairfield Ave Fl 4, Chicago, IL 60608-1782 | 2020-10-01 |
| 1841804879 | Chicago Poly Clinic LLC | Clinic/Center | 2446 W Devon Ave, Chicago, IL 60659-1913 | 2020-09-08 |
| 1386258226 | Ortho Spine Surgical LLC | Clinic/Center | 1925 E 95th St Ste 220, Chicago, IL 60617-4710 | 2020-09-08 |
| 1821607425 | Desired Medical Services Incorporated | Clinic/Center | 371 Mackinaw Ave, Calumet City, IL 60409-2524 | 2020-07-29 |
| 1639787823 | Md Infusions, Pllc | Clinic/Center | 666 Dundee Rd Ste 1800, Northbrook, IL 60062-2727 | 2020-07-14 |
| 1407474083 | Staten Family Practice Pllc | Clinic/Center | 500 W Virginia Ave, Gillespie, IL 62033-1025 | 2020-07-09 |
| 1629696679 | Serenity Internal Medicine & Wellness Center | Clinic/Center | 3330 W 177th St # 2d-1, Hazel Crest, IL 60429-2184 | 2020-07-07 |
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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.