| Bromenn Family Health Clinic | |
|
1300 Franklin Ave Ste 100 Normal IL 61761-3676 | |
| (309) 454-1400 | |
| Not Available |
| Full Name | Bromenn Family Health Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1300 Franklin Ave Ste 100, Normal, Illinois |
| Authorized Official Name and Position | Aron Klein (CFO) |
| Authorized Official Contact | 3092682410 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bromenn Family Health Clinic 1304 Franklin Ave Normal IL 61761-3558 Ph: (309) 454-1400 | Bromenn Family Health Clinic 1300 Franklin Ave Ste 100 Normal IL 61761-3676 Ph: (309) 454-1400 |
| NPI Number | 1104442615 |
|---|---|
| Provider Enumeration Date | 06/20/2020 |
| Last Update Date | 06/20/2020 |
| Medicare PECOS PAC ID | 8921429499 |
|---|---|
| Medicare Enrollment ID | O20200716000187 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104442615 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Nabih Ramadan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1508826314 PECOS PAC ID: 0941105654 Enrollment ID: I20040102000189 |
| Provider Name | Sandra C Roland |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1659321545 PECOS PAC ID: 0446149868 Enrollment ID: I20040313000238 |
| Provider Name | Hai C Nguyen |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1699777185 PECOS PAC ID: 1456243930 Enrollment ID: I20040329000765 |
| Provider Name | Alison E Sanker |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1386623494 PECOS PAC ID: 9133118714 Enrollment ID: I20040510000192 |
| Provider Name | Shilpa I Mehta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174616411 PECOS PAC ID: 4385611284 Enrollment ID: I20040910001061 |
| Provider Name | Stephen Christopher Pilcher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265454607 PECOS PAC ID: 9133012461 Enrollment ID: I20041022000098 |
| Provider Name | Shane C Fogo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063446318 PECOS PAC ID: 2365408606 Enrollment ID: I20041208000245 |
| Provider Name | Edward W Pegg |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1043392160 PECOS PAC ID: 8527076389 Enrollment ID: I20060405000344 |
| Provider Name | Todd O Kettering |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972619526 PECOS PAC ID: 3678626280 Enrollment ID: I20090729000743 |
| Provider Name | Deborah Singleton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639279839 PECOS PAC ID: 9133258130 Enrollment ID: I20100601000660 |
| Provider Name | Dionna M Pendleton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063668994 PECOS PAC ID: 4183817752 Enrollment ID: I20101112000683 |
| Provider Name | Brian J Wheatley |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1114149770 PECOS PAC ID: 0143490243 Enrollment ID: I20110829000361 |
| Provider Name | Mai U Wilhour |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1912285024 PECOS PAC ID: 2567637218 Enrollment ID: I20111208000612 |
| Provider Name | Jonathan D Benson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972887982 PECOS PAC ID: 1759535214 Enrollment ID: I20130208000357 |
| Provider Name | Ihor V Melnytskyy |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1184882789 PECOS PAC ID: 7315183654 Enrollment ID: I20130411000357 |
| Provider Name | Adam Daniel Houghton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568783439 PECOS PAC ID: 1557523586 Enrollment ID: I20131015001016 |
| Provider Name | Nicole L Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770974800 PECOS PAC ID: 9335467513 Enrollment ID: I20150420001386 |
| Provider Name | Desha N Cobb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578951075 PECOS PAC ID: 7214256619 Enrollment ID: I20150506002692 |
| Provider Name | Prerak Navinchandra Patel |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1992060230 PECOS PAC ID: 8123254422 Enrollment ID: I20150803001399 |
| Provider Name | Amir Afsar Khan |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1366638074 PECOS PAC ID: 7416041157 Enrollment ID: I20150803002472 |
| Provider Name | Ahmad Zabad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780021774 PECOS PAC ID: 9638460306 Enrollment ID: I20160628000951 |
| Provider Name | Alicia C Layton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053854323 PECOS PAC ID: 2062792062 Enrollment ID: I20161209000024 |
| Provider Name | Anthony Cienfuegos |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1073027462 PECOS PAC ID: 2466710967 Enrollment ID: I20171211000331 |
| Provider Name | Wael A Hassaneen Mostafa |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1376830745 PECOS PAC ID: 1557662095 Enrollment ID: I20180806000218 |
| Provider Name | Andrew Keto |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831578293 PECOS PAC ID: 3173827417 Enrollment ID: I20180918001300 |
| Provider Name | Sara Katherine Maffit |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1578065504 PECOS PAC ID: 9032454251 Enrollment ID: I20181217001636 |
| Provider Name | Brittany B Price |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1710364492 PECOS PAC ID: 5991019671 Enrollment ID: I20190501002001 |
| Provider Name | Jordan Forney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285154799 PECOS PAC ID: 5294005849 Enrollment ID: I20200724000124 |
| Provider Name | David Velasco |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1609360965 PECOS PAC ID: 4082965231 Enrollment ID: I20200831001731 |
| Provider Name | Joseph Tarran |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1679093454 PECOS PAC ID: 2062781636 Enrollment ID: I20201205000258 |
| Provider Name | Cora Bennett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912524703 PECOS PAC ID: 5496162281 Enrollment ID: I20210323001023 |
| Provider Name | Stephanie Finn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649631854 PECOS PAC ID: 7214236074 Enrollment ID: I20210903000473 |
| Provider Name | Joyce Ann Smith |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1871812982 PECOS PAC ID: 4183811979 Enrollment ID: I20210916003276 |
| Provider Name | Jennifer S Pemble |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811248651 PECOS PAC ID: 3274783386 Enrollment ID: I20220218002338 |
| Provider Name | Sourabh Lahoti |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1265776165 PECOS PAC ID: 1456665892 Enrollment ID: I20220708000440 |
| Provider Name | Qi Xiao |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1437690724 PECOS PAC ID: 7911276894 Enrollment ID: I20230215001910 |
| Provider Name | Robert E Worthen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942920129 PECOS PAC ID: 3476926676 Enrollment ID: I20230309001890 |
| Provider Name | Daniel Nwankwo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639526007 PECOS PAC ID: 2860735248 Enrollment ID: I20230413001718 |
| Provider Name | Jian Zhang |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1992729750 PECOS PAC ID: 9335139898 Enrollment ID: I20230621002169 |
| Provider Name | Sri Mahathi Priyanka Kalipatnapu |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1558898817 PECOS PAC ID: 4284908914 Enrollment ID: I20230720000583 |
| Provider Name | Noah Mckittrick |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1902197312 PECOS PAC ID: 1951533074 Enrollment ID: I20230822001759 |
| Provider Name | Jillianne Nanadiego |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1619598133 PECOS PAC ID: 6406270891 Enrollment ID: I20230822002498 |
| Provider Name | Karl Magsamen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033202536 PECOS PAC ID: 8921084187 Enrollment ID: I20230830000412 |
| Provider Name | Mohammed Elshamy |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1982066056 PECOS PAC ID: 9335426485 Enrollment ID: I20230918003687 |
| Provider Name | Ahmed Mohammad Khan |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1770915670 PECOS PAC ID: 0840424610 Enrollment ID: I20230919000222 |
| Provider Name | Tresa Lanelle Nesbitt |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1609154483 PECOS PAC ID: 9638499817 Enrollment ID: I20231002003499 |
| Provider Name | John Mark Pool |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1134338114 PECOS PAC ID: 5496818395 Enrollment ID: I20231011001823 |
| Provider Name | Muhammad Ali Naveed |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1093291502 PECOS PAC ID: 1951640580 Enrollment ID: I20231019002876 |
| Provider Name | Heather Ann Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780366419 PECOS PAC ID: 5799131991 Enrollment ID: I20231024003502 |
| Provider Name | Kathryn Mcdaniel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871211946 PECOS PAC ID: 9133575087 Enrollment ID: I20231027003302 |
| Provider Name | Julie Rae Wetmore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295955193 PECOS PAC ID: 2163688524 Enrollment ID: I20231114001876 |
| Provider Name | Ryan Mallory |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1548674096 PECOS PAC ID: 4183849912 Enrollment ID: I20231220003283 |
| Provider Name | Braxton Mcclung |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1497934202 PECOS PAC ID: 1850553934 Enrollment ID: I20240125002994 |
| Provider Name | Steven J Karidas |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1396940342 PECOS PAC ID: 0941391478 Enrollment ID: I20240222001263 |
| Provider Name | J Rubin |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1720036312 PECOS PAC ID: 9436056215 Enrollment ID: I20240404003474 |
| Provider Name | Alissa Macdonald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811643109 PECOS PAC ID: 7517344914 Enrollment ID: I20240410002586 |
| Provider Name | Deborah Trimble |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1619557352 PECOS PAC ID: 1153863493 Enrollment ID: I20240603001169 |
Johnson Chiropractic, Sc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 310 Susan Dr, Suite 2, Normal, IL 61761 Phone: 309-808-1123 Fax: 309-808-1516 | |
Ambulatory Medical Associates Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2010 Jacobssen Dr, Normal, IL 61761 Phone: 309-452-0995 Fax: 309-862-0961 | |
Digestive Disease Consultants Ltd Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1302 Franklin Ave, #4800, Normal, IL 61761 Phone: 309-454-5900 Fax: 309-454-2820 | |
Bromenn Family Health Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1300 Franklin Ave, Suite 100, Normal, IL 61761 Phone: 309-268-3761 Fax: 309-268-5620 | |
Carle West Physician Group Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1302 Franklin Ave Ste 3400, Normal, IL 61761 Phone: 309-556-8295 | |
Mid-central Illinois Gastroenterology, Ltd. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2200 Jacobssen Dr, Suite B, Normal, IL 61761 Phone: 309-451-1123 Fax: 309-451-1212 |