Individual provider Active NPI

Julie A Quam, PA

  • Physician Assistant
  • Galesburg, IL
National Provider Identifier
1447527882
Registry record updated Nov 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085-004235 Issued in IL
Practice address
3375 N Seminary St
Galesburg, IL 61401-1251
Phone
(309) 343-5114
Fax
(309) 343-7859
NPI assigned
Nov 30, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085-004235 IL Primary

Addresses

Primary practice location

3375 N Seminary St
Galesburg, IL 61401-1251

Mailing address

3375 N Seminary St
Galesburg, IL 61401-1251
Phone (309) 343-5114

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120306000552 IL Practitioner - Physician Assistant 4789843087 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085-004235ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Multi-Specialty Group CurrentSince Jan 1, 2016 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
St Mary Medical Center Physician Assistant Past Accepting new patients

Locations

3375 N Seminary St
Galesburg, IL 61401
Phone (309) 343-5114

530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553

5405 N Knoxville Ave
Peoria, IL 61614
Phone (309) 691-4410

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1322611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322611200000",
    "number": "1447527882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3375 N SEMINARY ST",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614011251",
            "telephone_number": "309-343-5114",
            "fax_number": "309-343-7859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3375 N SEMINARY ST",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614011251",
            "telephone_number": "309-343-5114",
            "fax_number": "309-343-7859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUAM",
        "first_name": "JULIE",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-30",
        "last_updated": "2011-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-004235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galesburg, IL

Sources for this page

Verify at the official NPI Registry.