Illinois Valley Primary Care, LTD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

ILLINOIS VALLEY PRIMARY CARE, LTD

Practice address

1209 Starfire Dr
#4
Ottawa, IL 61350-1614

Phone

(815) 434-4900

Fax

(815) 434-2765

NPI assigned

Aug 5, 2007

Organization subpart

No

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

Authorized official

Name

Dawn Miesner, D.O.

Title

Owner/Physician

Phone

(815) 434-4900

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191283200000",
    "number": "1851582928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1209 STARFIRE DR",
            "address_2": "#4",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613501614",
            "telephone_number": "815-434-4900",
            "fax_number": "815-434-2765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 STARFIRE DR",
            "address_2": "#4",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613501614",
            "telephone_number": "815-434-4900",
            "fax_number": "815-434-2765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS VALLEY PRIMARY CARE, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-05",
        "last_updated": "2007-10-02",
        "status": "A",
        "authorized_official_last_name": "MIESNER",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "815-434-4900",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carmen Leigh Hooper, FNP-BC
• Nicole M Hoxsey, PT
• Cheng C Hsieh, PA-C
• Illinois Valley Counseling Services
• Illinois Valley Eye Inst
• Illinois Valley Surgical Associates, SC
• Infinity-Meds LLP
• Integrative Primary Care Inc
• Kate E Jaegle, APN, CNP
• Amit Brij Jamnadas, M.D.

• Internal Medicine Physician in Ottawa, IL
• Providers in Ottawa, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2007; 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.