Prairie Point Obstetrics and Gynecology LTD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

PRAIRIE POINT OBSTETRICS AND GYNECOLOGY LTD

Practice address

1675 Bethany Rd
Suite C
Sycamore, IL 60178-3160

Phone

(815) 899-8080

Fax

(815) 899-8002

NPI assigned

Jul 9, 2006

Last updated

Feb 5, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Paul A Dubrick, MDNPI 1558345637

Title

Director/Physician

Phone

(815) 899-8080

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Chantal Annette-Van Houten Manhart, ARNP

  • Family Nurse Practitioner
  • Rochelle, IL
  • NPI 1265576185
  Medicare reassignment NPD
• Alisha M Wesley, MSN, CNM, APRN

  • Advanced Practice Midwife
  • Sycamore, IL
  • NPI 1649810987
  Medicare reassignment NPD
• Nichole Elizabeth Wiepert, M.D.

  • Obstetrics & Gynecology Physician
  • Sycamore, IL
  • NPI 1871735290
  Medicare reassignment NPD
• Paul A Dubrick, MD

  • Obstetrics & Gynecology Physician
  • Sycamore, IL
  • NPI 1558345637
  NPD Authorized official
• Bryan M Kruskol, DO

  • Obstetrics & Gynecology Physician
  • Sycamore, IL
  • NPI 1497739569
  Medicare reassignment

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202169600000",
    "number": "1841223070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 BETHANY RD",
            "address_2": "SUITE C",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783160",
            "telephone_number": "815-899-8080",
            "fax_number": "815-899-8002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 BETHANY RD",
            "address_2": "SUITE C",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783160",
            "telephone_number": "815-899-8080",
            "fax_number": "815-899-8002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE POINT OBSTETRICS AND GYNECOLOGY LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2008-02-05",
        "status": "A",
        "authorized_official_last_name": "DUBRICK",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR/PHYSICIAN",
        "authorized_official_telephone_number": "815-899-8080",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD IL",
            "identifier": "01932073",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shannon Pociecha, LCPC
• Amanda R Pollnow, AT-C
• Odolina Calderon Pope, FNP-C
• Heather C. Porter, M.A. CCC-SLP
• Prairie Health Care, LTD (Kishwaukee Medical Associates)
• Prairie View Dental LLC
• Patrice A Pritchard, RN
• Proactive Chiropractic & Laser Center, LLC
• Professional Services for Anxiety-Related Disorders, LLC (OCD & Anxiety Treatment Specialists)
• Professional Services in Health Psychology, LTD (LivingRite, The Center for Behavioral Health, LTD)

• Obstetrics & Gynecology Physician in Sycamore, IL
• Providers in Sycamore, IL by specialty
• Obstetrics & Gynecology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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.