OTTAWA MEDICAL CENTER, PC


Address: 1614 E Norris Dr, Ottawa, IL 61350-3681
Phone: 8154313265

OTTAWA MEDICAL CENTER, PC (NPI# 1992879126) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1992879126
Entity Type Organization
Organization Name OTTAWA MEDICAL CENTER, PC
Practice Address 1614 E Norris Dr
Ottawa
IL 61350-3681
Practice Telephone 8154313265
Practice Fax Number 8154313259
Mailing Telephone 8154313265
Mailing Fax Number 8154313259
Enumeration Date 2006-11-20
Last Update Date 2020-08-22
Authorized Official Name JILL L LOWE (ACCOUNTING CLERK)
Authorized Official Telephone 8154313265
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QR0206X Clinic/Center
Specialization: Radiology, Mammography
9032426 IL Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
FDA FACILITY ID NUMBER 159632 01

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1184649410 Ottawa Medical Center, PC Clinic/Center 1614 E Norris Dr, Ottawa, IL 61350-3681 2006-07-13

Office Location

Street Address 1614 E NORRIS DR
City OTTAWA
State IL
Zip Code 61350-3681

Providers in the same location

NPI Name Taxonomy Address Enumeration
1356336952 Gueorgui S Gueorguiev Family Medicine 1614 E Norris Dr, Ottawa, IL 61350-3681 2005-09-20
1740769298 Loni F Nolte Social Worker 1614 E Norris Dr, Ottawa, IL 61350-3681 2018-08-07
1609227081 Heather M Johnston Nurse Practitioner 1614 E Norris Dr, Ottawa, IL 61350-3681 2016-06-27
1013382209 Sherri L Albert Nurse Practitioner 1614 E Norris Dr, Ottawa, IL 61350-3681 2015-12-14
1730560822 Austin David Martin Family Medicine 1614 E Norris Dr, Ottawa, IL 61350-3681 2015-06-15
1659771863 Justine Mucci Nurse Practitioner 1614 E Norris Dr, Ottawa, IL 61350-3681 2014-08-26
1760891766 Danielle Pagano Registered Nurse 1614 E Norris Dr, Ottawa, IL 61350 2014-08-05
1659620342 Kayla A Simons Nurse Practitioner 1614 E Norris Dr, Ottawa, IL 61350-3681 2012-09-10
1063749596 Ottawa Regional Medical Center Inc. Family Medicine 1614 E Norris Dr, Ottawa, IL 61350-3681 2009-11-04
1548429509 Ami M Dose Nurse Practitioner 1614 E Norris Dr, Ottawa, IL 61350-3681 2008-06-05
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1306336359 Yulandist Jeannie Brown Licensed Practical Nurse 617 Columbus St, Ottawa, IL 61350 2018-05-15
1881071272 Ashlee Herbold Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 1718 N 2525th Rd, Ottawa, IL 61350 2015-05-05
1053702365 Wanda Rohl Social Worker 3735 E 1453 Rd, Ottawa, IL 61350 2015-02-09
1538550868 Erin Rose Boe Physical Therapist 2872 Columbus St, Unit 300, Ottawa, IL 61350 2015-02-09
1346572757 Rebecca Samolitis Counselor 116 W Lafayette St, Suite 8, Ottawa, IL 61350 2010-02-10
1235383266 Timothy I Miller O.d. P.C. Optometrist 107 E. Mckinley Rd., Ottawa, IL 61350 2008-11-04
1427204676 Leo John Meagher Counselor 218 West Madison St, Ottawa, IL 61350 2008-08-07
1598938755 Radiation Oncology of Northern Illinois LLC Radiology 1200 Starfire Dr, Ottawa, IL 61350 2008-04-09
1154538510 Serenityonwheels, Inc. Counselor Serenity On Wheels, Inc. 630 Columbus Street, Ste # 214, Ottawa, IL 61350 2007-05-16
1205040904 Dixie Devry Occupational Therapist 2532 Reynolds Manor, Ottawa, IL 61350 2007-05-10
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Taxonomy Information

Taxonomy Code 261QR0206X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Radiology, Mammography

Taxonomy Definition

Definition to come...

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1144729716 St. Elizabeth's Hospital of The Hospital Sisters of The Third Order Of Clinic/Center 180 South Third Street Suite 101, Belleville, IL 62220 2018-02-08
1295869071 Resurrection Services Clinic/Center 420 William Street, 2nd Floor, River Forest, IL 60305-1920 2007-03-15
1952778474 Alton Multispecialists, Ltd. Clinic/Center 1 Professional Dr, Alton, IL 62002-5068 2015-09-01
1154798882 Alton Multispecialists, Ltd. Clinic/Center 1 Professional Dr, Alton, IL 62002-5068 2015-08-28
1588001093 Southernmost Illinois Community Health Improvement Corporation Clinic/Center 13289 Kessler Rd, Cairo, IL 62914-3101 2013-05-24
1033446810 Resurrection Ambulatory Services Clinic/Center 420 William St, 2nd Floor, River Forest, IL 60305-1920 2009-11-16
1750554960 Simply The Breast, LLC Clinic/Center 500 N Maple St, Effingham, IL 62401-2005 2008-04-09
1598840423 Sterling Rock Falls Clinic, Ltd Clinic/Center 101 E Miller Rd, Sterling, IL 61081-1252 2006-10-26
1497857593 Belleville Imaging, Inc. Clinic/Center 15 Park Pl, Swansea, IL 62226-2968 2006-09-01
1245287143 Ft. Jesse Imaging Center LLC Clinic/Center 2200 Fort Jesse Rd, Suite 130, Normal, IL 61761-6286 2006-05-27
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Competitor

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City OTTAWA
Zip Code 61350

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Dataset Information

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.

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