CARLE BROMENN MEDICAL CENTER (NPI# 1962424036) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962424036 |
| Entity Type | Organization |
| Organization Name | CARLE BROMENN MEDICAL CENTER |
| Other Organization Name | ADVOCATE BROMENN MEDICAL CENTER |
| Practice Address |
1304 Franklin Ave Normal IL 61761-3558 |
| Practice Telephone | 3094541400 |
| Mailing Telephone | 3094541400 |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2020-10-19 |
| Authorized Official Name | ARON KLEIN (VICE PRESIDENT FINANCE) |
| Authorized Official Telephone | 3092682410 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | 370673462 | IL | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS - ACUTE HOSP | 098 | 01 |
| Other Name | Type Code |
|---|---|
| Advocate BroMenn Medical Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104442615 | Carle Bromenn Medical Center | Clinic/Center | 1300 Franklin Ave Ste 100, Normal, IL 61761-3676 | 2020-06-20 |
| 1306867866 | Carle Bromenn Medical Center | Rehabilitation Unit | 1304 Franklin Ave, Normal, IL 61761-3558 | 2006-07-21 |
| Street Address |
1304 FRANKLIN AVE |
| City | NORMAL |
| State | IL |
| Zip Code | 61761-3558 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962489815 | Advocate Health and Hospitals Corporation | Pharmacy | 1304 Franklin Ave, Normal, IL 61761-3558 | 2005-12-30 |
| 1588292239 | Christa Jaglinski | Family Medicine | 1304 Franklin Ave, Normal, IL 61761-3558 | 2020-03-30 |
| 1659910438 | Adam Joseph Mckillip | Physician Assistant | 1304 Franklin Ave, Normal, IL 61761-3558 | 2019-12-27 |
| 1285196220 | Ondrea K Timmermann | Student in an Organized Health Care Education/Training Program | 1304 Franklin Ave, Normal, IL 61761-3558 | 2019-04-01 |
| 1700348752 | Brian Man Chan | Family Medicine | 1304 Franklin Ave, Normal, IL 61761-3558 | 2019-04-01 |
| 1801358627 | Nicholas Gurganious | Physician Assistant | 1304 Franklin Ave, Normal, IL 61761-3558 | 2019-04-01 |
| 1841752854 | Uyen Thanh Pham Le | Student in an Organized Health Care Education/Training Program | 1304 Franklin Ave, Normal, IL 61761-3558 | 2019-04-01 |
| 1477013613 | Ahmad Emara | Student in an Organized Health Care Education/Training Program | 1304 Franklin Ave, Normal, IL 61761-3558 | 2019-03-22 |
| 1477017275 | Jae Rock Shim | Registered Nurse | 1304 Franklin Ave, Normal, IL 61761-3558 | 2019-01-25 |
| 1477048932 | Brittany R. Bolt | Psychiatry & Neurology | 1304 Franklin Ave, Normal, IL 61761-3558 | 2018-06-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629681796 | Brittany Nicole Mekley | Nurse Practitioner | 201 N. University, Normal, IL 61761 | 2020-08-28 |
| 1679108971 | Krystal Halliday | Occupational Therapist | 1815 N Towanda Barnes Rd, Normal, IL 61761 | 2020-03-06 |
| 1265915474 | Laine E Burek | Nurse Practitioner | 1765 Bradford Ln., Normal, IL 61761 | 2018-09-13 |
| 1801389986 | Ashley Michelle James | Specialist/Technologist | 347 S. University St, Normal, IL 61761 | 2018-06-12 |
| 1447750708 | Shelley R. Ruch | Specialist/Technologist, Other | 1604 Visa Drive, Ste 1, Normal, IL 61761 | 2018-02-13 |
| 1497275069 | Mclean County Nursing Home | Non-emergency Medical Transport (VAN) | 901 N. Main St, Normal, IL 61761 | 2017-06-23 |
| 1235673666 | Megan Threm | Registered Nurse | 900 Franklin Ave Community Health Care Clinic, Normal, IL 61761 | 2016-12-04 |
| 1437513553 | Tiesha Smith | Specialist | 1800 Rockingham Dr, Apt 1d, Normal, IL 61761 | 2016-04-06 |
| 1285031658 | New Day Recovery | Community/Behavioral Health | 402 Summit, Normal, IL 61761 | 2014-12-01 |
| 1174927701 | Alyssa Marie Bruck | Occupational Therapist | 700 N Walnut St, Normal, IL 61761 | 2014-10-10 |
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| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831420520 | Advocate Health and Hospitals Corp. | General Acute Care Hospital | 1304 Franklin Ave, Normal, IL 61761-3558 | 2010-01-20 |
| 1487981916 | Advocate Health and Hospitals Corporation | General Acute Care Hospital | 1304 Franklin Ave, Normal, IL 61761-3558 | 2009-11-04 |
| 1184808404 | Bromenn Healthcare, Inc. | General Acute Care Hospital | 1304 Franklin Ave, Normal, IL 61761 | 2007-12-21 |
| 1396929618 | Bromenn Regional Medical Center | General Acute Care Hospital | 1304 Franklin Ave, Normal, IL 61761 | 2007-12-21 |
| 1932298874 | Bromenn Healthcare Pharmacy | General Acute Care Hospital | 1304 Franklin Ave, Pharmacy, Normal, IL 61704 | 2006-10-11 |
| 1699870063 | Bromenn Healthcare Open Mri | General Acute Care Hospital | 1304 Franklin Ave, Normal, IL 61761-3558 | 2006-09-13 |
| 1144241605 | Bromenn Healthcare Inc | General Acute Care Hospital | 1304 Franklin Ave, Normal, IL 61761-3558 | 2006-07-21 |
| 1487675948 | Bromenn Healthcare Inc | General Acute Care Hospital | 1304 Franklin Ave, Normal, IL 61761-3558 | 2006-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619442266 | Pipeline-west Suburban Medical Center, LLC | General Acute Care Hospital | West Suburban Medical Center, 3 Erie Court, Oak Park, IL 60302-2519 | 2018-10-10 |
| 1093241275 | Northwest Community Hospital | General Acute Care Hospital | 2704 Royal Saint Georges Ct, Saint Charles, IL 60174-8754 | 2017-05-05 |
| 1831620632 | Macneal Hospital | General Acute Care Hospital | 665 Grove Dr Apt 112, Buffalo Grove, IL 60089-4038 | 2017-03-23 |
| 1801337506 | University of Chicago Medical Center | General Acute Care Hospital | 1122 Paysphere Cir, Chicago, IL 60674-0011 | 2017-03-14 |
| 1861935181 | Sarah Landon | General Acute Care Hospital | 6407 Martin St, Crystal Lake, IL 60014-4959 | 2016-11-19 |
| 1942750831 | Advocate Good Samaritan | General Acute Care Hospital | 4427 Woodward Ave, Downers Grove, IL 60515 | 2016-10-04 |
| 1063960870 | Mid America Emergency Medicine | General Acute Care Hospital | 700 N First St, Springfield, IL 62781-0001 | 2016-09-21 |
| 1336598937 | Daniel Benjamin Holt Jr. | General Acute Care Hospital | 2448 N Seminary Ave, Apt 2b, Chicago, IL 60614-7445 | 2016-06-06 |
| 1841650942 | Latoyia Roman | General Acute Care Hospital | 6756 S Oglesby Ave, Unit 1, Chicago, IL 60649-1316 | 2016-03-02 |
| 1306203583 | Rush University Medical Center | General Acute Care Hospital | 4536 N Greenview Ave Apt 2n, Chicago, IL 60640-5475 | 2016-01-19 |
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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.