Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Provena Service Corporation

Organization Family Medicine Physician · NPI 1134314602

Provena Service Corporation is a Family Medicine Physician in Danville, Illinois. Licensed in Illinois. Registered with an NPI since 2007.

Licensed in
IL
In the registry since
2007

Practice location Address checks out

405 Sheridan St
Danville, IL 61832-4451
Phone: (217) 431-6330
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X (IL)

Record details

NPI number1134314602
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationProvena Service Corporation
Authorized official Daniel Boland — Financial Reporting Specialist · (815) 806-3111
Other names Provena Medical Group
NPI enumeratedSeptember 7, 2007
Last updated in NPPESApril 20, 2008
Mailing address9223 W Saint Francis Rd, Frankfort, IL 60423-8330

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