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PROVENA MEDICAL GROUP
NPI 1134314602
Family Medicine in Danville, IL

Active since September 07, 2007
405 SHERIDAN ST, DANVILLE, IL 61832(217) 431-6330 Get Directions Write a Review

NPPES record last updated: April 20, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Provena Medical Group NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROVENA MEDICAL GROUP (NPI 1134314602) is a healthcare organization registered as a family medicine in Danville, Illinois and active in the NPI registry since September 2007. The organization lists Daniel Boland, Financial Reporting Specialist, as its authorized official.

NPPES Registry Identity

NPI1134314602
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePROVENA SERVICE CORPORATION
Location Address405 SHERIDAN STDanville, IL 61832-4451
Mailing Address9223 W Saint Francis RdFrankfort, IL 60423-8330 · (815) 806-3111
Phone(217) 431-6330
Organization SubpartYes
Authorized OfficialDaniel BolandFinancial Reporting Specialist · (815) 806-3111
Enumeration DateSeptember 7, 2007
Last NPPES UpdateApril 20, 2008
✔ NPI 1134314602 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
405 SHERIDAN ST, Danville, IL 61832
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Other Names 1

Doing Business AsProvena Medical Group

Other Identifiers 2

Medicare PIN148932
Medicaid=========004IL

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BAYVIEW FAMILY CLINIC LTD
Point of Service
405 SHERIDAN ST
DANVILLE, IL 61832
Vermilion County (217) 446-3259
HELPING HANDS MEDICAL CLINIC LTD
Clinic/Center (Primary Care)
405 SHERIDAN ST
DANVILLE, IL 61832
Vermilion County (217) 446-1100

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Provena Service Corporation's NPI number?

The NPI number for Provena Service Corporation is 1134314602. It was assigned to this organization in the NPPES registry on September 7, 2007. The provider is doing business as Provena Medical Group.

Where is Provena Service Corporation located?

Provena Service Corporation is located at 405 Sheridan St, Danville, IL 61832. The listed phone number is (217) 431-6330.

What is Provena Service Corporation's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Provena Service Corporation was last updated on April 20, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.