Prairie Healthcare, LTD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PRAIRIE HEALTHCARE, LTD

Practice address

1 E Countyline Rd
Sandwich, IL 60548-2178

Phone

(815) 786-2722

NPI assigned

Apr 9, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Denise A Brennan

Title

Office Manager

Phone

(815) 786-2722

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Sandwich Family Practice Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Prairie Health Care, LTD

  • Family Medicine Physician
  • Sycamore, IL
  • NPI 1871718551

  O20040427000790

  Same enrollment

Locations

Practitioners 2

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

• Mark Allan Drendel, MD

  • Family Medicine Physician
  • Sycamore, IL
  • NPI 1639128358
  NPD
• Michael W Thornton, MD

  • Family Medicine Physician
  • Sycamore, IL
  • NPI 1699703405
  NPD

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202342400000",
    "number": "1497878086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 E COUNTYLINE RD",
            "city": "SANDWICH",
            "state": "IL",
            "postal_code": "605482178",
            "telephone_number": "815-786-2722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 E COUNTYLINE RD",
            "city": "SANDWICH",
            "state": "IL",
            "postal_code": "605482178",
            "telephone_number": "815-786-2722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE HEALTHCARE, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-09",
        "last_updated": "2008-02-07",
        "status": "A",
        "authorized_official_last_name": "BRENNAN",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "815-786-2722",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSSBLUE SHIELD",
            "identifier": "1921614",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sandwich Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Lynn Pellicano, PSYD
• Petersen Health Business, LLC
• Audrey Peterson, ALMFT
• Allison Peuler
• Pharmacy Operations, Inc
• Bruce Carter Ramquist, RPH
• Katherine C Reed, APRN, CNP
• Delilah Ann Renegar, D.C.
• Dawn Kim Reynolds, RN
• Rezin Orthopedic & Sports Medicine, SC

• Family Medicine Physician in Sandwich, IL
• Providers in Sandwich, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2008; 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.