OrganizationActive
Provena Service Corporation
NPI 1255526687 · Pediatrics Physician · Danville, IL
Provena Service Corporation is a Pediatrics Physician organization in Danville, IL (NPI 1255526687).
Provider details
- NPI number
- 1255526687
- Entity type
- Organization
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Provena Service Corporation
- Organization subpart
- Yes
- Authorized official
- Daniel Boland, Financial Reporting Manager(815) 806-3111
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(88/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
102 N Logan Ave
Danville, IL 61832-8513
Phone: (217) 442-5863
Fax: (217) 442-5040
Street-level locationGet directions
Mailing address
9223 W Saint Francis Rd
Frankfort, IL 60423-8330
Other names (DBA / former)
- Doing business as
- Provena Medical Group
Registry dates
- Enumerated
- 2007-09-10
- Last updated
- 2008-04-20
Frequently asked questions
- What is Provena Service Corporation's NPI number?
- Provena Service Corporation's National Provider Identifier (NPI) is 1255526687, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Provena Service Corporation?
- Provena Service Corporation is classified in the NPPES registry as Pediatrics Physician (Allopathic & Osteopathic Physicians).
- Where is Provena Service Corporation located?
- Provena Service Corporation's practice location on file with NPPES is 102 N Logan Ave, Danville, IL 61832-8513.
- What is Provena Service Corporation's phone number?
- The practice phone number listed in the NPPES registry for Provena Service Corporation is (217) 442-5863.
- Who is the authorized official for Provena Service Corporation?
- The authorized official listed on Provena Service Corporation's NPPES record is Daniel Boland, Financial Reporting Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Provena Service Corporation's NPI active?
- Yes — Provena Service Corporation's NPI (1255526687) is active in the NPPES registry as of the last update on 2008-04-20.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.