| Osfmg - Bloomington | |
|
302 Saint Joseph Dr Bloomington IL 61701-3506 | |
| (800) 589-6070 | |
| (309) 683-5969 |
| Full Name | Osfmg - Bloomington |
|---|---|
| Speciality | Family Medicine |
| Location | 302 Saint Joseph Dr, Bloomington, Illinois |
| Authorized Official Name and Position | Robert C. Sehring (CEO OSF HEALTHCARE SYSTEM) |
| Authorized Official Contact | 3096552850 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Osfmg - Bloomington 124 Sw Adams St Peoria IL 61602-1308 Ph: (309) 655-2850 | Osfmg - Bloomington 302 Saint Joseph Dr Bloomington IL 61701-3506 Ph: (800) 589-6070 |
| NPI Number | 1871547414 |
|---|---|
| Provider Enumeration Date | 05/19/2006 |
| Last Update Date | 03/14/2024 |
| Medicare PECOS PAC ID | 8921901620 |
|---|---|
| Medicare Enrollment ID | O20040129001106 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871547414 | NPI | - | NPPES |
| 5723443 | Other | IL | BLUE SHIELD |
| Provider Name | Peter B Draper |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1750433132 PECOS PAC ID: 9032199518 Enrollment ID: I20040723001104 |
| Provider Name | Douglas A Ward |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1497782700 PECOS PAC ID: 0244202059 Enrollment ID: I20040811001175 |
| Provider Name | Jonas V Sidrys |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1124068275 PECOS PAC ID: 1557320959 Enrollment ID: I20041008001426 |
| Provider Name | John W Hafner |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1255360715 PECOS PAC ID: 8325075146 Enrollment ID: I20050725000129 |
| Provider Name | Donald R Wallace |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1700899788 PECOS PAC ID: 5890722508 Enrollment ID: I20050725000888 |
| Provider Name | Vanessa L Pitts |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1588691687 PECOS PAC ID: 4183654346 Enrollment ID: I20050817000328 |
| Provider Name | Jaidev Chand Soni |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1811978752 PECOS PAC ID: 9032120324 Enrollment ID: I20060530000132 |
| Provider Name | Crystal L Sweeney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649466111 PECOS PAC ID: 5698861169 Enrollment ID: I20071013000021 |
| Provider Name | Robin Maniurski |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1508977133 PECOS PAC ID: 6406817253 Enrollment ID: I20071227000375 |
| Provider Name | Mark P Gaudio |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1053514414 PECOS PAC ID: 6103982483 Enrollment ID: I20090312000034 |
| Provider Name | Julie A Lewis |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1013068667 PECOS PAC ID: 2860546207 Enrollment ID: I20090819000319 |
| Provider Name | Benjamin O Kemp |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1699095067 PECOS PAC ID: 9234262270 Enrollment ID: I20100728000641 |
| Provider Name | Joseph William Hauter |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1366673436 PECOS PAC ID: 1456538107 Enrollment ID: I20110606000340 |
| Provider Name | Neal D Rushforth |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1811121361 PECOS PAC ID: 3577727874 Enrollment ID: I20120618000694 |
| Provider Name | Jennifer A Berkley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295088391 PECOS PAC ID: 2062641723 Enrollment ID: I20140129001866 |
| Provider Name | Austin J Lamb |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1013202530 PECOS PAC ID: 2062645468 Enrollment ID: I20140509001809 |
| Provider Name | Vivian C Lau |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1437443777 PECOS PAC ID: 1456584788 Enrollment ID: I20140512001079 |
| Provider Name | Stephanie J Kok |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1740575976 PECOS PAC ID: 7911120282 Enrollment ID: I20140514001924 |
| Provider Name | Audra L Rushforth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467877407 PECOS PAC ID: 4385867845 Enrollment ID: I20140602001234 |
| Provider Name | Anthony J Buecker |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1043504368 PECOS PAC ID: 0648491118 Enrollment ID: I20141027000586 |
| Provider Name | William F Bond |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1245268127 PECOS PAC ID: 4587608435 Enrollment ID: I20150318002703 |
| Provider Name | Jill M White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033500327 PECOS PAC ID: 8921319542 Enrollment ID: I20150623001062 |
| Provider Name | Andrew J Farraher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316314446 PECOS PAC ID: 7911214028 Enrollment ID: I20150922000269 |
| Provider Name | Brandon B Bleess |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1306284161 PECOS PAC ID: 3779804612 Enrollment ID: I20160527000120 |
| Provider Name | Jennifer M Speirer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437502192 PECOS PAC ID: 7416242391 Enrollment ID: I20160817002283 |
| Provider Name | Justin J Couch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922451681 PECOS PAC ID: 0446546196 Enrollment ID: I20160907001680 |
| Provider Name | Stosh T Eichenauer |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1932514106 PECOS PAC ID: 7719208685 Enrollment ID: I20170628002312 |
| Provider Name | David Kosturakis |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1952669277 PECOS PAC ID: 5496995953 Enrollment ID: I20170801002475 |
| Provider Name | Matthew K Fischer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1497169338 PECOS PAC ID: 0648591586 Enrollment ID: I20170808002795 |
| Provider Name | Kelley Elizabeth Smith |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1366874471 PECOS PAC ID: 4284946773 Enrollment ID: I20170829004296 |
| Provider Name | Hannah K Donahue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760909626 PECOS PAC ID: 9032484381 Enrollment ID: I20171012001200 |
| Provider Name | Sarah Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750802674 PECOS PAC ID: 7911266184 Enrollment ID: I20180116000030 |
| Provider Name | Theresa M Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447758107 PECOS PAC ID: 9032479928 Enrollment ID: I20180214002939 |
| Provider Name | Christopher Branham |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1720475049 PECOS PAC ID: 3375858897 Enrollment ID: I20180820001377 |
| Provider Name | Shawn C Joseph |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1891172888 PECOS PAC ID: 1254646771 Enrollment ID: I20180920001152 |
| Provider Name | Elizabeth A Franklin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003308347 PECOS PAC ID: 4880948645 Enrollment ID: I20181114000001 |
| Provider Name | Lee D Raube |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1861848871 PECOS PAC ID: 3971895046 Enrollment ID: I20181203000518 |
| Provider Name | Michael N Daley |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1992159206 PECOS PAC ID: 4981997707 Enrollment ID: I20190729000241 |
| Provider Name | Alex Ireland |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1881083640 PECOS PAC ID: 0345522488 Enrollment ID: I20191002001605 |
| Provider Name | Crystal D Reed |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1588626576 PECOS PAC ID: 0244240794 Enrollment ID: I20191025000758 |
| Provider Name | Anthony J Lahood |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1851825863 PECOS PAC ID: 8628342219 Enrollment ID: I20191213000801 |
| Provider Name | Luke Knapp |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1790218527 PECOS PAC ID: 2668800913 Enrollment ID: I20200326001837 |
| Provider Name | Susana Meschede |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1932553294 PECOS PAC ID: 5698068823 Enrollment ID: I20200519001436 |
| Provider Name | Greg M Hermann |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1912392564 PECOS PAC ID: 9830405406 Enrollment ID: I20200619001293 |
| Provider Name | Jacob P Holton |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1821527201 PECOS PAC ID: 6507137148 Enrollment ID: I20200826001331 |
| Provider Name | Charles R Heinzmann |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1376040477 PECOS PAC ID: 2668725193 Enrollment ID: I20201214000871 |
| Provider Name | Kyle M Stang |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1750743134 PECOS PAC ID: 1658643317 Enrollment ID: I20210714001664 |
| Provider Name | Laurie Lisa Herscher |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1750473856 PECOS PAC ID: 0244413821 Enrollment ID: I20231026003696 |
Planned Parenthood Of Illinois Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1319 N Veterans Pkwy, Suite 3-a, Bloomington, IL 61704 Phone: 309-827-4014 Fax: 309-828-6309 | |
Empowerme Medical Group, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1815 N Towanda Barnes Rd, Bloomington, IL 61705 Phone: 844-502-7996 | |
Central Illinois Center For Wellness, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2501 E College Ave Ste C, Bloomington, IL 61704 Phone: 309-807-5356 Fax: 309-807-5291 | |
Central Illinois Preventive Services Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1603 Tullamore Ave Ste A, Bloomington, IL 61704 Phone: 309-808-6407 | |
Primary Care Specialists, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2 Airline Dr, Suite 500, Bloomington, IL 61704 Phone: 636-579-6778 | |
Central Illinois Pediatric Associates Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2427 Maloney Dr, Bloomington, IL 61704 Phone: 309-663-1011 | |
Summit Family Medical Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 902 N Hershey Rd, Bloomington, IL 61704 Phone: 309-662-6880 Fax: 309-662-7385 |