NPIMap

Organization Active NPI

Bromenn Physician Management Corporation

Doing business as Illinois Heart & Lung Associates

  • Cardiovascular Disease Physician
  • Normal, IL
National Provider Identifier
1225061393
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
BROMENN PHYSICIAN MANAGEMENT CORPORATION
Doing business as
Illinois Heart & Lung Associates
Practice address
1302 Franklin Ave
Suite 4500
Normal, IL 61761-3551
Phone
(309) 828-1166
Fax
(309) 862-0330
NPI assigned
Jul 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. William Brouwer
Title
President, Physicians Mgmnt Corp
Phone
(309) 268-2129

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RC0000X Primary
Pulmonary Disease PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RP1001X

Addresses

Primary practice location

1302 Franklin Ave
Suite 4500
Normal, IL 61761-3551

Mailing address

1302 Franklin Ave
Suite 4500
Normal, IL 61761-3551
Phone (309) 828-1166

Other identifiers 2

IdentifierTypeStateIssuer
212636OtherILMEDICARE GROUP NUMBER
05732097OtherILBCBS GROUP NUMBER

Other names 1

  • Illinois Heart & Lung Associates Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1225061393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 FRANKLIN AVE",
            "address_2": "SUITE 4500",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617613551",
            "telephone_number": "309-828-1166",
            "fax_number": "309-862-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 FRANKLIN AVE",
            "address_2": "SUITE 4500",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617613551",
            "telephone_number": "309-828-1166",
            "fax_number": "309-862-0330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROMENN PHYSICIAN MANAGEMENT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "BROUWER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT, PHYSICIANS MGMNT CORP",
        "authorized_official_telephone_number": "309-268-2129",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "212636",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "05732097",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Illinois Heart & Lung Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Normal, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.