Podzamsky Medical Services

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

036055223 Issued in IL

Legal business name

PODZAMSKY MEDICAL SERVICES

Practice address

301 S Bloomington St
Streator, IL 61364-2969

Phone

(815) 673-2441

Fax

(815) 672-2178

NPI assigned

Aug 12, 2009

Organization subpart

No

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

Authorized official

Name

John E Podzamsky, D.O.

Title

President

Phone

(309) 432-2441

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

Practitioners 3

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

• Sharon A Austin, CNP

  • Family Nurse Practitioner
  • Minonk, IL
  • NPI 1780669309
  NPD
• Patricia A Duffield, CNP

  • Family Nurse Practitioner
  • Streator, IL
  • NPI 1134104755
  NPD (past)
• Rose Mary Schaumberg, FNP

  • Family Nurse Practitioner
  • Lasalle, IL
  • NPI 1265514343
  NPD (past)

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

{
    "created_epoch": "1250035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355875200000",
    "number": "1700018538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 E. 7TH ST.",
            "city": "MINONK",
            "state": "IL",
            "postal_code": "61760",
            "telephone_number": "309-432-2515",
            "fax_number": "309-432-2160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S BLOOMINGTON ST",
            "city": "STREATOR",
            "state": "IL",
            "postal_code": "613642969",
            "telephone_number": "815-673-2441",
            "fax_number": "815-672-2178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PODZAMSKY MEDICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-12",
        "last_updated": "2012-12-19",
        "status": "A",
        "authorized_official_last_name": "PODZAMSKY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-432-2441",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "IL",
            "license": "036055223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036055223",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1225013840",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN - MINONK  ILLINOIS LOCATION OF SERVICE",
            "identifier": "645950",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN - STREATOR ILLINOIS LOCATION OF SERVICE",
            "identifier": "645951",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelissa L Peterson, DMD
• Phillips Investments, LLC - Streator Operations Series
• Kristy Ann Pierce-Schultz, LCSW
• Michelle Pitstick, OT
• Robert Patrick Pode, D.O.
• Sudha Pravinkumar, M.D
• Kaleb James Pytel, PT, DPT
• Qus Inc
• Monelyn R Rabago, PT
• Tracy Eileen Rampick

• Preferred Provider Organization in Streator, IL
• Providers in Streator, IL by specialty
• Preferred Provider Organization in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2012; 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.