Our Medical Center LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

209013778 Issued in IL

Legal business name

OUR MEDICAL CENTER LLC

Practice address

451 Dunham Rd Ste 300
Saint Charles, IL 60174-1431

Phone

(630) 521-3110

Fax

(630) 296-8965

NPI assigned

May 31, 2018

Organization subpart

No

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

Authorized official

Name

Cecilia Berumen, APRN FPANPI 1548621642

Title

Nurse Practitioner / Psych

Phone

(630) 521-3110

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

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

• Cecilia Berumen, APRN FPA

  • Psychiatric/Mental Health Nurse Practitioner
  • Saint Charles, IL
  • NPI 1548621642
  Medicare reassignment Authorized official
• Christina Kassenbrock, FNP

  • Family Nurse Practitioner
  • Elgin, IL
  • NPI 1437781606
  NPD (past)

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

{
    "created_epoch": "1527724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625702400000",
    "number": "1316439722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 DUNHAM RD STE 300",
            "city": "SAINT CHARLES",
            "state": "IL",
            "postal_code": "601741431",
            "telephone_number": "630-521-3110",
            "fax_number": "630-296-8965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 DUNHAM RD STE 300",
            "city": "SAINT CHARLES",
            "state": "IL",
            "postal_code": "601741431",
            "telephone_number": "630-521-3110",
            "fax_number": "630-296-8965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUR MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-31",
        "last_updated": "2021-07-08",
        "certification_date": "2020-12-07",
        "status": "A",
        "authorized_official_last_name": "BERUMEN",
        "authorized_official_first_name": "CECILIA",
        "authorized_official_title_or_position": "NURSE PRACTITIONER / PSYCH",
        "authorized_official_telephone_number": "630-521-3110",
        "authorized_official_credential": "APRN FPA"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209013778",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "IL",
            "license": "209013778",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1437547858",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chisom Christine Onyibor, RN
• Holly Orcutt, PHD
• Izabela Orzechowska
• Anne Osielski, LPC
• James R Otepka, LMFT
• Robert W Overdorf, DDS
• Renita Overstreet, MPT
• Christina Joy Oxley, LCPC
• Carlie M Ozarka, MPT
• Jeanette Dorit Pacanowski, CCC-SLP

• Psychiatric/Mental Health Nurse Practitioner in Saint Charles, IL
• Providers in Saint Charles, IL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.