NPIMap

Organization Active NPI

VA Illiana Healthcare System

  • Social Worker
  • Danville, IL
National Provider Identifier
1457734469
Registry record updated Jul 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6906-M Issued in AR
Legal business name
VA ILLIANA HEALTHCARE SYSTEM
Practice address
1901 E Main St
Mail Slot 122
Danville, IL 61832-5117
Phone
(217) 554-3755
Fax
(217) 554-4813
NPI assigned
Jul 8, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2015

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

Authorized official

Name
Ms. Bryanna Elyce Graham, LMSW
Title
Social Worker
Phone
(217) 554-3755

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 104100000X 6906-M AR Primary

Addresses

Primary practice location

1901 E Main St
Mail Slot 122
Danville, IL 61832-5117

Mailing address

6 Hedge CT
Champaign, IL 61821-2015

National Provider Directory

National Provider Directory
Tax ID family
Danville Vamc13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1901 E Main St
#122
Danville, IL 61832
Phone (217) 554-3755

NPI Registry JSON

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

{
    "created_epoch": "1436313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436313600000",
    "number": "1457734469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 HEDGE CT",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618212015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 E MAIN ST",
            "address_2": "MAIL SLOT 122",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618325117",
            "telephone_number": "217-554-3755",
            "fax_number": "217-554-4813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VA ILLIANA HEALTHCARE SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-08",
        "last_updated": "2015-07-08",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "BRYANNA",
        "authorized_official_middle_name": "ELYCE",
        "authorized_official_title_or_position": "SOCIAL WORKER",
        "authorized_official_telephone_number": "217-554-3755",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": "AR",
            "license": "6906-M",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2015; 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.