NPIMap

Organization Active NPI

Danville Pediatric Center

  • Health Maintenance Organization
  • Danville, IL
National Provider Identifier
1942476668
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
License
036-028934 Issued in IL
Legal business name
DANVILLE PEDIATRIC CENTER
Practice address
723 N Logan Ave
Danville, IL 61832-4384
Phone
(217) 446-3259
NPI assigned
May 2, 2008
Last updated
Jun 23, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2008

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

Authorized official

Name
Dr. Robert Elghammer
Title
M.D.
Phone
(217) 446-3259

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X 036-028934 IL Primary

Addresses

Primary practice location

723 N Logan Ave
Danville, IL 61832-4384

Mailing address

723 N Logan Ave
Danville, IL 61832-4384
Phone (217) 446-3259

Other identifiers 1

IdentifierTypeStateIssuer
036028934MedicaidIL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1209686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1942476668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "723 N LOGAN AVE",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618324384",
            "telephone_number": "217-446-3259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "723 N LOGAN AVE",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618324384",
            "telephone_number": "217-446-3259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANVILLE PEDIATRIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-02",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "ELGHAMMER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "217-446-3259",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "IL",
            "license": "036-028934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036028934",
            "state": "IL"
        }
    ],
    "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 Jun 23, 2008; 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.