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BROMENN HEALTHCARE HOSPITALS NPI 1396780854


NPI Information

NPI: 1396780854
Provider Name: BROMENN HEALTHCARE HOSPITALS

Other Name: BROMENN FAMILY HEALTH CLINIC

Classification: Family Medicine - 207QG0300X
Entity Type: Organization

Specialization: Geriatric Medicine

Address:
1300 FRANKLIN AVE
SUITE 100
NORMAL, IL
ZIP 61761
Phone: (309) 268-3761
Get Directions

BROMENN HEALTHCARE HOSPITALS is a geriatric medicine family medicine in Normal, IL. The provider is a family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. BROMENN HEALTHCARE HOSPITALS NPI is 1396780854. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Other Name Is Bromenn Family Health Clinic.

The provider's business location address is:

1300 FRANKLIN AVE
SUITE 100
NORMAL, IL
ZIP 61761-588
Phone: (309) 268-3761
Fax: (309) 268-5620

The provider's authorized official is Kathy O. Davis .
The authorized official title is Vp & Chief Information Officer and has the following contact phone number (309) 268-2410.

The enumeration date for this NPI number is 6/18/2006 and was last updated on 10/6/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207QG0300XFamily MedicineGeriatric MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
15715390OTHERILLINOISBLUE CROSS BLUE SHIELD
2209392MEDICARE ID-TYPE UNSPECIFIEDILLINOISGROUP NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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