Mr David A Braun, MD | |
1505 Eastland Dr, Suite 1100, Bloomington, IL 61701-3591 | |
(309) 663-2100 | |
(309) 663-8322 |
Full Name | Mr David A Braun |
---|---|
Gender | Male |
Speciality | Family Medicine |
Location | 1505 Eastland Dr, Bloomington, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1568422806 | NPI | - | NPPES |
IL2613 | Other | MEDICARE GROUP # | |
P00748543 | Other | RR INDIVIDUAL # | |
70254 | Other | IA | WELLMARK BCBS |
833120 | Other | IL | MEDICARE GROUP # |
SS# NOT ENTERED | Medicaid | IL | |
CA2264 | Other | RR MEDICARE GROUP # |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 036104222 (Illinois) | Primary |
207Q00000X | Family Medicine | 33372 (Iowa) | Secondary |
Entity Name | Advocate Health And Hospitals Corporation |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1700824455 PECOS PAC ID: 7810800935 Enrollment ID: O20031106000064 |
Mailing Address | Practice Location Address |
---|---|
Mr David A Braun, MD 1505 Eastland Dr, Suite 1100, Bloomington, IL 61701-3591 Ph: (309) 663-2100 | Mr David A Braun, MD 1505 Eastland Dr, Suite 1100, Bloomington, IL 61701-3591 Ph: (309) 663-2100 |
Dr. Justin James Holschbach, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 308 Saint Joseph Dr, Bloomington, IL 61701 Phone: 309-663-5050 Fax: 309-662-3401 | |
Jermy Enrique Crespo Gonzalez, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 2200 East Washington Street, Bloomington, IL 61701 Phone: 309-665-5996 | |
Stephen Belgrave, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1701 E College Ave, Bloomington, IL 61704 Phone: 309-664-3170 | |
Daniel Marley, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1701 E College Ave, Bloomington, IL 61704 Phone: 309-664-3170 | |
Mfowethu Theophilus Langeni, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 210 Saint Joseph Dr, Bloomington, IL 61701 Phone: 309-663-5050 Fax: 309-662-3401 | |
Shilpa Mehta, Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1505 Eastland Dr, Bloomington, IL 61701 Phone: 309-663-2100 Fax: 309-663-8322 | |
Kenneth Wayne Birge Jr., MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2502 E Empire St, Bloomington, IL 61704 Phone: 309-300-1031 |