PREMIER MEDICAL GROUP, LLC (NPI# 1942501978) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942501978 |
| Entity Type | Organization |
| Organization Name | PREMIER MEDICAL GROUP, LLC |
| Practice Address |
2102 E Washington St Bloomington IL 61701-4321 |
| Practice Telephone | 3096626200 |
| Practice Fax Number | 3096625017 |
| Mailing Telephone | 3096626200 |
| Mailing Fax Number | 3096625017 |
| Enumeration Date | 2010-11-08 |
| Last Update Date | 2010-11-08 |
| Authorized Official Name | MR. JOHN HESSE (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3096626200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians | ||
| N | 208200000X | Plastic Surgery | Allopathic & Osteopathic Physicians | ||
| N | 208800000X | Urology | Allopathic & Osteopathic Physicians | ||
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639468788 | Premier Medical Group, LLC | Obstetrics & Gynecology | 1505 Eastland Dr Ste 500, Bloomington, IL 61701-7905 | 2011-03-29 |
| 1427357227 | Premier Medical Group, LLC | Urology | 1401 Eastland Dr Ste B, Bloomington, IL 61701-3514 | 2011-03-18 |
| 1275825432 | Premier Medical Group, LLC | Orthopaedic Surgery | 2005 Jacobssen Dr, Suite A, Normal, IL 61761-6287 | 2011-05-06 |
| 1184913881 | Premier Medical Group, LLC | Obstetrics & Gynecology | 1300 Franklin Ave, Suite 360, Normal, IL 61761-3592 | 2011-04-04 |
| 1891084653 | Premier Medical Group, LLC | Obstetrics & Gynecology | 107 N Regency Dr, Bloomington, IL 61701-3505 | 2011-04-01 |
| 1841589835 | Premier Medical Group, LLC | Internal Medicine | 1302 Franklin Ave, #4800, Normal, IL 61761-3551 | 2011-03-31 |
| 1720377690 | Premier Medical Group, LLC | Surgery | 1537 Fort Jesse Rd, Suite A, Normal, IL 61761-6192 | 2011-03-31 |
| 1487943593 | Premier Medical Group, LLC | Plastic Surgery | 1505 Eastland Dr, Suite 350, Bloomington, IL 61701-3534 | 2011-03-30 |
| 1497054720 | Premier Medical Group, LLC | Podiatrist | 1512 W Reynolds St Ste A, Pontiac, IL 61764-9788 | 2011-03-25 |
| 1992004683 | Premier Medical Group, LLC | Surgery | 1505 Eastland Dr, Suite 2300, Bloomington, IL 61701-3534 | 2011-03-21 |
| Street Address |
2102 E WASHINGTON ST |
| City | BLOOMINGTON |
| State | IL |
| Zip Code | 61701-4321 |
| 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 | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| 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 Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124459219 | Matilde Francois | Surgery | 1505 Eastland Dr Ste 2300, Bloomington, IL 61701 | 2013-11-27 |
| 1356687313 | John Warren Frisch | Surgery | 21 Country Club Pl, Bloomington, IL 61701-3486 | 2012-12-19 |
| 1407048036 | Charles R. Mckeen, M.d., PC | Surgery | 413 W 1st St, Bloomington, IN 47403-2403 | 2007-08-17 |
| 1023119740 | Terrence M Greene | Surgery | 419 W 1st St, Bloomington, IN 47403-2403 | 2006-09-26 |
| 1447355383 | Surgical Associates of Bloomington, Ill,ltd | Surgery | 1404 Eastland Drive, Suite 104, Bloomington, IL 61701 | 2006-09-14 |
| 1124089313 | Camilo Santiago | Surgery | 421 W 1st St, Bloomington, IN 47403 | 2006-03-29 |
| 1932194511 | Fadi Haddad | Surgery | 822 W 1st St, Suite 8, Bloomington, IN 47403-2384 | 2005-09-20 |
| 1508863945 | James Nicholas Topolgus Jr. | Surgery | 1419 S Sare Rd, Bloomington, IN 47401-4431 | 2005-06-30 |
| 1396188819 | Katherine Elizabeth Smiley | Surgery | 421 W 1st St, Bloomington, IN 47403 | 2013-04-15 |
| 1992004683 | Premier Medical Group, LLC | Surgery | 1505 Eastland Dr, Suite 2300, Bloomington, IL 61701-3534 | 2011-03-21 |
| Find all providers in BLOOMINGTON | ||||
| 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.