Provena Medical Group

LBN: Provena Service Corporation
Provena Medical Group is an health care organization with primary practice located at 405 Sheridan St , Danville IL 61832-4451. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Provena Service Corporation can be contacted via phone (217) 431-6330, or through Boland, Daniel via phone (815) 806-3111.

Contact Information

Primary practice address
405 Sheridan St Danville IL 61832-4451
Phone: (217) 431-6330
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Boland, Daniel
Phone: (815) 806-3111

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X Illinois

Profile Details

NPI number 1134314602
LBN Legal business name Provena Service Corporation
DBA Doing business as Provena Medical Group
Authorized official Boland, Daniel
Entity Organization
Organization subpart 1 Yes
Enumeration date Sep 7th, 2007
Last updated Apr 20th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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