| Alexian Brothers Medical Group | |
|
2380 E Dempster St Des Plaines IL 60016-4839 | |
| (855) 692-6482 | |
| Not Available |
| Full Name | Alexian Brothers Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 2380 E Dempster St, Des Plaines, Illinois |
| Authorized Official Name and Position | Reinhold Llerena (CEO) |
| Authorized Official Contact | 8556926482 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alexian Brothers Medical Group 2380 E Dempster St Des Plaines IL 60016-4839 Ph: (855) 692-6482 | Alexian Brothers Medical Group 2380 E Dempster St Des Plaines IL 60016-4839 Ph: (855) 692-6482 |
| NPI Number | 1588775647 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 05/30/2024 |
| Medicare PECOS PAC ID | 7517863178 |
|---|---|
| Medicare Enrollment ID | O20031212000374 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588775647 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | M Mufaddal Hamadeh |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1598757718 PECOS PAC ID: 4385542083 Enrollment ID: I20040122000095 |
| Provider Name | Vasia A Ahmed |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1992797047 PECOS PAC ID: 4284536186 Enrollment ID: I20040122000118 |
| Provider Name | Brian J Leahy |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1679505358 PECOS PAC ID: 6103728043 Enrollment ID: I20040122000369 |
| Provider Name | Robert O Maganini |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1831166776 PECOS PAC ID: 9436051042 Enrollment ID: I20040123000718 |
| Provider Name | Papa Win Delacruz |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1497727200 PECOS PAC ID: 7911800420 Enrollment ID: I20040131000086 |
| Provider Name | Naheed A Ali |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811971559 PECOS PAC ID: 9436047198 Enrollment ID: I20040305000517 |
| Provider Name | Thomas E Garrity |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1134105125 PECOS PAC ID: 5294623674 Enrollment ID: I20040308000775 |
| Provider Name | Andrei M Pop |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1417156365 PECOS PAC ID: 8224020631 Enrollment ID: I20040402000865 |
| Provider Name | Bachar Hamad |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1780690040 PECOS PAC ID: 5092701284 Enrollment ID: I20040504000655 |
| Provider Name | David S Shaw |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1952484644 PECOS PAC ID: 2365431517 Enrollment ID: I20040511001521 |
| Provider Name | Wayne H Franklin |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1538120472 PECOS PAC ID: 3779574884 Enrollment ID: I20040519000163 |
| Provider Name | Elizabeth A Gerson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992749394 PECOS PAC ID: 8921099417 Enrollment ID: I20040522000216 |
| Provider Name | Isabel A Gonzalez |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1225148414 PECOS PAC ID: 8921071325 Enrollment ID: I20040813001210 |
| Provider Name | Jeffrey D Eye |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780662460 PECOS PAC ID: 3971571563 Enrollment ID: I20040921001229 |
| Provider Name | Pamela E Smith |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1821060039 PECOS PAC ID: 5890763171 Enrollment ID: I20040923001009 |
| Provider Name | Renato Mendoza Fontanilla |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1285635995 PECOS PAC ID: 5799754560 Enrollment ID: I20040928001179 |
| Provider Name | Ghassan Zalzaleh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992704035 PECOS PAC ID: 7517936099 Enrollment ID: I20040930000994 |
| Provider Name | Jay J Virchow |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417931510 PECOS PAC ID: 1759341530 Enrollment ID: I20041015000428 |
| Provider Name | Phithao J Nguyen |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1740261585 PECOS PAC ID: 3678537537 Enrollment ID: I20041119000197 |
| Provider Name | Vipan K Gupta |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1356393730 PECOS PAC ID: 9133184732 Enrollment ID: I20041124000169 |
| Provider Name | Paul A Meyer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235139619 PECOS PAC ID: 3476504085 Enrollment ID: I20050204000019 |
| Provider Name | Michael J Meyer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043219322 PECOS PAC ID: 7012968621 Enrollment ID: I20050204000130 |
| Provider Name | Jack R Chamberlin |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1215980321 PECOS PAC ID: 4385626340 Enrollment ID: I20050408000764 |
| Provider Name | Sheri B Merchant |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1043248248 PECOS PAC ID: 7719975796 Enrollment ID: I20050510001163 |
| Provider Name | Szymon S Rosenblatt |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1952370306 PECOS PAC ID: 3072557685 Enrollment ID: I20050615000069 |
| Provider Name | Michael Rezak |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1003975897 PECOS PAC ID: 4284679069 Enrollment ID: I20050622000673 |
| Provider Name | German D Calonje |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1215042205 PECOS PAC ID: 2961439310 Enrollment ID: I20050718000984 |
| Provider Name | Maliha J Shareef |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1013981026 PECOS PAC ID: 9133152895 Enrollment ID: I20050913001133 |
| Provider Name | John K Song |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1922099084 PECOS PAC ID: 5395779631 Enrollment ID: I20050926000530 |
| Provider Name | Timothy Malisch |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326070210 PECOS PAC ID: 6800815630 Enrollment ID: I20051122000069 |
| Provider Name | Pankaj Chhangani |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1952364838 PECOS PAC ID: 4385665181 Enrollment ID: I20051208000263 |
| Provider Name | Elizabeth A Bello |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1043204910 PECOS PAC ID: 4183646292 Enrollment ID: I20060103000390 |
| Provider Name | Konstantinos D Kostas |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629047469 PECOS PAC ID: 1153344197 Enrollment ID: I20060105000442 |
| Provider Name | Judith Ann Thommes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063411510 PECOS PAC ID: 9436168127 Enrollment ID: I20060407000010 |
| Provider Name | Marko J Jachtorowycz |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1073597894 PECOS PAC ID: 9436161429 Enrollment ID: I20060609000153 |
| Provider Name | Ha J Lee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881624377 PECOS PAC ID: 6305849746 Enrollment ID: I20060824000390 |
| Provider Name | Hossam Hamdi Mohamed Abdelsalam |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1972543080 PECOS PAC ID: 5698782175 Enrollment ID: I20060914000435 |
| Provider Name | Ann L West |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1801816277 PECOS PAC ID: 1456357144 Enrollment ID: I20061020000403 |
| Provider Name | Monica Mahajan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295708410 PECOS PAC ID: 2567456585 Enrollment ID: I20061128000318 |
| Provider Name | Kimberley A Scholl |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396777371 PECOS PAC ID: 1355340449 Enrollment ID: I20061219000456 |
| Provider Name | Mohammed S Homsi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1932272952 PECOS PAC ID: 0143229161 Enrollment ID: I20061220000157 |
| Provider Name | Asad Rafiq |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1295879666 PECOS PAC ID: 5799887170 Enrollment ID: I20070305000162 |
| Provider Name | Tabitha A Watts |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1750469987 PECOS PAC ID: 9436253408 Enrollment ID: I20070330000432 |
| Provider Name | Kanu K Panchal |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1659463503 PECOS PAC ID: 5092812032 Enrollment ID: I20070525000265 |
| Provider Name | Allison Ruth Rittman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740491331 PECOS PAC ID: 1658472667 Enrollment ID: I20070720000421 |
| Provider Name | Sylvia M Scrima |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962629576 PECOS PAC ID: 4486748852 Enrollment ID: I20070915000172 |
| Provider Name | Nadine C Lamond |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1235114661 PECOS PAC ID: 7810084456 Enrollment ID: I20071030000354 |
| Provider Name | Mariusz T Koziol |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1376752634 PECOS PAC ID: 0749379394 Enrollment ID: I20071204000612 |
| Provider Name | Jyothi V Thota |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1205808102 PECOS PAC ID: 1153403365 Enrollment ID: I20080128000221 |
| Provider Name | Amir A Turayhi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336200500 PECOS PAC ID: 0648352211 Enrollment ID: I20080205000225 |
| Provider Name | Jerry Andrews |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205875507 PECOS PAC ID: 8426132986 Enrollment ID: I20080225000053 |
| Provider Name | Elaine R Cheng |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1891885778 PECOS PAC ID: 2961589536 Enrollment ID: I20080407000443 |
| Provider Name | Jayanthi R Ramadurai |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1639196330 PECOS PAC ID: 2668543992 Enrollment ID: I20080613000495 |
| Provider Name | Jonathan W Wallace |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1568422012 PECOS PAC ID: 8224109566 Enrollment ID: I20080613000594 |
| Provider Name | Abdul A Mazin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1477500056 PECOS PAC ID: 0749352268 Enrollment ID: I20080627000435 |
| Provider Name | Patricia J Lamp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891968921 PECOS PAC ID: 5597837997 Enrollment ID: I20080630000440 |
| Provider Name | Debra B Selip |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1053360974 PECOS PAC ID: 1850464785 Enrollment ID: I20080724000776 |
| Provider Name | Alkesh P Patel |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1376728196 PECOS PAC ID: 5799859344 Enrollment ID: I20080731000188 |
| Provider Name | Erwin G Szela |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1932171949 PECOS PAC ID: 2860455052 Enrollment ID: I20080923000516 |
| Provider Name | Farhan Hanif |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1821272162 PECOS PAC ID: 7214095629 Enrollment ID: I20081028000790 |
| Provider Name | Joel Manaligod |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1881769214 PECOS PAC ID: 5496815730 Enrollment ID: I20081117000699 |
| Provider Name | Daniel R Winkelman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1033284526 PECOS PAC ID: 1355403437 Enrollment ID: I20081224000303 |
| Provider Name | Mary Tillema |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1346214319 PECOS PAC ID: 5496817371 Enrollment ID: I20081231000348 |
| Provider Name | Alex B Lipowich |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1083640734 PECOS PAC ID: 1850335571 Enrollment ID: I20090110000201 |
| Provider Name | Catherine E Theorell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104082890 PECOS PAC ID: 7315004736 Enrollment ID: I20090330000120 |
| Provider Name | Wasif H Shirazi |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1558336149 PECOS PAC ID: 8628015344 Enrollment ID: I20090331000075 |
| Provider Name | Subramanya S Rao |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1740256783 PECOS PAC ID: 2264479989 Enrollment ID: I20090331000098 |
| Provider Name | Himadri M Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548250384 PECOS PAC ID: 6204873482 Enrollment ID: I20090427000392 |
| Provider Name | Janine A Tanner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417183823 PECOS PAC ID: 4880745678 Enrollment ID: I20090708000376 |
| Provider Name | Constantine V Godellas |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1740251222 PECOS PAC ID: 6103977996 Enrollment ID: I20090708000411 |
| Provider Name | Shadi Latta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427255447 PECOS PAC ID: 5092867903 Enrollment ID: I20090723000059 |
| Provider Name | Meredith K Martin Johnston |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1275783300 PECOS PAC ID: 4082767967 Enrollment ID: I20090727000188 |
| Provider Name | Celeste M Galizia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508850819 PECOS PAC ID: 7719027580 Enrollment ID: I20091230000040 |
| Provider Name | Robert J Macdonald |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679640379 PECOS PAC ID: 7214062454 Enrollment ID: I20100312000945 |
| Provider Name | Charles D Kalenowski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023046414 PECOS PAC ID: 2163550468 Enrollment ID: I20100506000801 |
| Provider Name | Carey M Bacalar |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1376549394 PECOS PAC ID: 1254469067 Enrollment ID: I20100514000073 |
| Provider Name | Elizabeth Mlynarczyk |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1003038688 PECOS PAC ID: 3870624497 Enrollment ID: I20100625000855 |
| Provider Name | John Wilkerson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609807981 PECOS PAC ID: 6507990355 Enrollment ID: I20100816000155 |
| Provider Name | Stephen Behnke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427081272 PECOS PAC ID: 7911031760 Enrollment ID: I20100816000194 |
| Provider Name | Michael J Osten |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124059498 PECOS PAC ID: 4688708449 Enrollment ID: I20100816000290 |
| Provider Name | Michael G Dunleavy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811927239 PECOS PAC ID: 2466586847 Enrollment ID: I20100820000538 |
| Provider Name | Mark E Collins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508894882 PECOS PAC ID: 2961536354 Enrollment ID: I20100820000626 |
| Provider Name | Bryan Bertoglio |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1588871388 PECOS PAC ID: 1557436441 Enrollment ID: I20100824001092 |
| Provider Name | George Kostas Bovis |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1750389268 PECOS PAC ID: 3274657358 Enrollment ID: I20100825001137 |
| Provider Name | Concetta M Forchetti |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1184656852 PECOS PAC ID: 3971629163 Enrollment ID: I20100924000766 |
| Provider Name | Laetitia Stamboliu |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1306985627 PECOS PAC ID: 9931225182 Enrollment ID: I20100925000143 |
| Provider Name | Amar Hamad |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1598765166 PECOS PAC ID: 6406916220 Enrollment ID: I20101102001220 |
| Provider Name | Aristidis Hatzidimitriadis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508027855 PECOS PAC ID: 0042405961 Enrollment ID: I20101117000378 |
| Provider Name | Mary A Hurley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417272212 PECOS PAC ID: 8820287535 Enrollment ID: I20110112000184 |
| Provider Name | Richard Kampanatkosol |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1851619647 PECOS PAC ID: 1456533983 Enrollment ID: I20110304000476 |
| Provider Name | Carol W Saffold |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1871563627 PECOS PAC ID: 3375558489 Enrollment ID: I20110315000415 |
| Provider Name | Reinhold Llerena |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053349720 PECOS PAC ID: 0143403048 Enrollment ID: I20110331000074 |
| Provider Name | Rowena M Abasolo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891099776 PECOS PAC ID: 2062696297 Enrollment ID: I20110412000558 |
| Provider Name | Naveed Bari |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1578665949 PECOS PAC ID: 5193811263 Enrollment ID: I20110422000134 |
| Provider Name | Stephen Rittman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104857473 PECOS PAC ID: 2961689716 Enrollment ID: I20110606000157 |
| Provider Name | Vipul Singla |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1164448387 PECOS PAC ID: 8022296177 Enrollment ID: I20110621000184 |
| Provider Name | Elizabeth A Nanney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649449950 PECOS PAC ID: 9537347059 Enrollment ID: I20110630000608 |
| Provider Name | Brian J Donohue |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093971806 PECOS PAC ID: 7911177001 Enrollment ID: I20110829000161 |
| Provider Name | Denise M Barnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598902272 PECOS PAC ID: 1456525583 Enrollment ID: I20111129000382 |
| Provider Name | Anne Marie E Drahos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083934442 PECOS PAC ID: 2365609682 Enrollment ID: I20120127000983 |
| Provider Name | Elizabeth Kelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972873735 PECOS PAC ID: 7315104999 Enrollment ID: I20120209000351 |
| Provider Name | Vanja Cuk |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215022074 PECOS PAC ID: 0648432062 Enrollment ID: I20120501000763 |
| Provider Name | Candy I Tolentino-salvador |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1437308194 PECOS PAC ID: 2961665534 Enrollment ID: I20120517000358 |
| Provider Name | Anita Iyer |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1174515035 PECOS PAC ID: 4981868999 Enrollment ID: I20120601000520 |
| Provider Name | Tammy S Zweeres |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255690574 PECOS PAC ID: 3577728203 Enrollment ID: I20120703000331 |
| Provider Name | Peter J Johnson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1053517151 PECOS PAC ID: 7012164957 Enrollment ID: I20120828000280 |
| Provider Name | Gerard J Abood |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1629237227 PECOS PAC ID: 5991999815 Enrollment ID: I20120829000684 |
| Provider Name | Tehui M Ma |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1467618553 PECOS PAC ID: 3870742125 Enrollment ID: I20121002000771 |
| Provider Name | Nour Akhras |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1003930736 PECOS PAC ID: 6204964489 Enrollment ID: I20121019000663 |
| Provider Name | Ami N Shah |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1578651899 PECOS PAC ID: 0345342291 Enrollment ID: I20121023000743 |
| Provider Name | Sarah E Perkins |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1013173061 PECOS PAC ID: 3870743610 Enrollment ID: I20121101000243 |
| Provider Name | Tiffany Amber Deriggi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982975694 PECOS PAC ID: 9335390160 Enrollment ID: I20121103000076 |
| Provider Name | Xiaohong Yu |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1568614329 PECOS PAC ID: 9032362272 Enrollment ID: I20130121000103 |
| Provider Name | Preeti Jhaveri |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1639292741 PECOS PAC ID: 0143386474 Enrollment ID: I20130430000640 |
| Provider Name | David Vallejo |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1699085381 PECOS PAC ID: 2466699541 Enrollment ID: I20130508000640 |
| Provider Name | Sanjay Yadla |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1629286067 PECOS PAC ID: 9537315221 Enrollment ID: I20130509000325 |
| Provider Name | Cynthia A Brincat |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1497871792 PECOS PAC ID: 5092853895 Enrollment ID: I20130618000608 |
| Provider Name | Faisal Amdani |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1689874349 PECOS PAC ID: 3173762184 Enrollment ID: I20130625000144 |
| Provider Name | Scott R Geraghty |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871715995 PECOS PAC ID: 8022286343 Enrollment ID: I20130625000608 |
| Provider Name | Glendon C Burress |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1639190200 PECOS PAC ID: 0345480810 Enrollment ID: I20130703000425 |
| Provider Name | Assaad Youssef Semaan |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1841457975 PECOS PAC ID: 7618117961 Enrollment ID: I20130709000625 |
| Provider Name | Joyce Anuradha Gemson Victor |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1154646594 PECOS PAC ID: 7214178904 Enrollment ID: I20130723000231 |
| Provider Name | Michael R Peplow |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851607634 PECOS PAC ID: 3779724364 Enrollment ID: I20130724000438 |
| Provider Name | Priya Dileep |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447562905 PECOS PAC ID: 7012158660 Enrollment ID: I20130725000062 |
| Provider Name | Tiffany J Diaz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730403387 PECOS PAC ID: 4789825712 Enrollment ID: I20130802000192 |
| Provider Name | Gina A Mathew |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1992933204 PECOS PAC ID: 3375785033 Enrollment ID: I20130808000258 |
| Provider Name | Janice K Ko |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124348339 PECOS PAC ID: 6406099357 Enrollment ID: I20130826000525 |
| Provider Name | Mona M Gomaa |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1225247976 PECOS PAC ID: 3375774557 Enrollment ID: I20140401002159 |
| Provider Name | Karina Dahlerus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164849477 PECOS PAC ID: 9436372059 Enrollment ID: I20140528001315 |
| Provider Name | Crystal Jones Wadyal |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1700097094 PECOS PAC ID: 2365610433 Enrollment ID: I20140624000160 |
| Provider Name | Najma M Lokhandwala |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1063603868 PECOS PAC ID: 1759443823 Enrollment ID: I20140715000649 |
| Provider Name | Sarah D Mccormick |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1306157789 PECOS PAC ID: 7012132624 Enrollment ID: I20140715000903 |
| Provider Name | Michael Brunner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215166319 PECOS PAC ID: 2961627591 Enrollment ID: I20140715001536 |
| Provider Name | Natasha R Harvey |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1902187867 PECOS PAC ID: 5698991537 Enrollment ID: I20140729002052 |
| Provider Name | Christina Benedict |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1265731434 PECOS PAC ID: 5092932418 Enrollment ID: I20140808000644 |
| Provider Name | Fareesa G Khan |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1790702322 PECOS PAC ID: 3678522034 Enrollment ID: I20140813002825 |
| Provider Name | Sunny K Sharma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245526482 PECOS PAC ID: 7618100389 Enrollment ID: I20140814002091 |
| Provider Name | Angela A Ganan Popa |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1093004079 PECOS PAC ID: 6204056021 Enrollment ID: I20140930000573 |
| Provider Name | Palosha Ahmed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033407069 PECOS PAC ID: 5991925505 Enrollment ID: I20141002001790 |
| Provider Name | Waleed A Abbasi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1487941969 PECOS PAC ID: 0345481768 Enrollment ID: I20141113001536 |
| Provider Name | Margaret R Meznarick |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1801295985 PECOS PAC ID: 6608198437 Enrollment ID: I20141206000220 |
| Provider Name | Fares Hamad |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1275831521 PECOS PAC ID: 6204158850 Enrollment ID: I20141210000130 |
| Provider Name | Yevgeniya Sorokin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1497051239 PECOS PAC ID: 5496903759 Enrollment ID: I20150210001303 |
| Provider Name | Armughan Bangash |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1962679852 PECOS PAC ID: 3375682578 Enrollment ID: I20150313002318 |
| Provider Name | Anita Pachikara |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1487833927 PECOS PAC ID: 7012103450 Enrollment ID: I20150415002234 |
| Provider Name | Patricia Webber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205227642 PECOS PAC ID: 3072832773 Enrollment ID: I20150430001902 |
| Provider Name | Ashish Shah |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1780847384 PECOS PAC ID: 5698991164 Enrollment ID: I20150521002711 |
| Provider Name | Keith Wayne Schmidt |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1407162746 PECOS PAC ID: 2466763115 Enrollment ID: I20150622001330 |
| Provider Name | Khalid Naseer |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1851341366 PECOS PAC ID: 9335177047 Enrollment ID: I20150630001727 |
| Provider Name | Nicole C Steineke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356699987 PECOS PAC ID: 5294040499 Enrollment ID: I20150818003479 |
| Provider Name | Stephen W Pichler |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1952676280 PECOS PAC ID: 3870808959 Enrollment ID: I20150819006483 |
| Provider Name | Michele R Bey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295159846 PECOS PAC ID: 6709191562 Enrollment ID: I20150824000538 |
| Provider Name | Jennifer Solomos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518220904 PECOS PAC ID: 1254649155 Enrollment ID: I20150925001405 |
| Provider Name | Kaiz S Asif |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1679729875 PECOS PAC ID: 6204078876 Enrollment ID: I20150929000026 |
| Provider Name | Maureen Lynn Ryan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811308844 PECOS PAC ID: 3072821511 Enrollment ID: I20151001002101 |
| Provider Name | Mary Christine V Deato |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992172944 PECOS PAC ID: 9931417383 Enrollment ID: I20151005000663 |
| Provider Name | Ankur P Dave |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1063705259 PECOS PAC ID: 9638397102 Enrollment ID: I20151014000924 |
| Provider Name | Thomas J Mccaffrey |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1396852638 PECOS PAC ID: 2961396387 Enrollment ID: I20151015002337 |
| Provider Name | Laura Wargo |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1235590910 PECOS PAC ID: 1951609924 Enrollment ID: I20160408000207 |
| Provider Name | Kate M Reed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164798641 PECOS PAC ID: 3375842735 Enrollment ID: I20160506000251 |
| Provider Name | Bhranti C Langaliya |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093151151 PECOS PAC ID: 6103116769 Enrollment ID: I20160609002096 |
| Provider Name | Ryan Shea Fitzgerald |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346689411 PECOS PAC ID: 8820392921 Enrollment ID: I20160711002447 |
| Provider Name | Cecilia M Chui |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1306161880 PECOS PAC ID: 6406090190 Enrollment ID: I20160921002622 |
| Provider Name | Moina Uddin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1902112188 PECOS PAC ID: 7012133572 Enrollment ID: I20160929001491 |
| Provider Name | Taaha A Shakir |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1811143290 PECOS PAC ID: 9133362320 Enrollment ID: I20161018001445 |
| Provider Name | Shruti Gupta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811256399 PECOS PAC ID: 9436463528 Enrollment ID: I20161028001118 |
| Provider Name | Shruti A Fadia |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1669634770 PECOS PAC ID: 4688893969 Enrollment ID: I20161101000864 |
| Provider Name | Shaheen F Misbah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649566407 PECOS PAC ID: 4284938580 Enrollment ID: I20170103000250 |
| Provider Name | Ashley N Bos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487195905 PECOS PAC ID: 6204113392 Enrollment ID: I20170427000304 |
| Provider Name | Brenda Streicher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699209528 PECOS PAC ID: 2062799018 Enrollment ID: I20170501001532 |
| Provider Name | Avani H Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366971970 PECOS PAC ID: 5496024705 Enrollment ID: I20170629002486 |
| Provider Name | Ruchi B Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619317229 PECOS PAC ID: 2769605294 Enrollment ID: I20170703000254 |
| Provider Name | Marta J Arroyo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1851412415 PECOS PAC ID: 3072883446 Enrollment ID: I20170717003676 |
| Provider Name | Sana Hoda |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1891113643 PECOS PAC ID: 3779887849 Enrollment ID: I20170726004231 |
| Provider Name | Nicole M Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740653872 PECOS PAC ID: 5799056529 Enrollment ID: I20170811002338 |
| Provider Name | Nathaniel Koo |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1467626184 PECOS PAC ID: 0143586404 Enrollment ID: I20171102002078 |
| Provider Name | Jasmine A Munoz |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1942543665 PECOS PAC ID: 0547564445 Enrollment ID: I20171115002690 |
| Provider Name | Atif Baqai |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1508066192 PECOS PAC ID: 8921220419 Enrollment ID: I20171117000857 |
| Provider Name | Lauren T Astrug |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1780950386 PECOS PAC ID: 4587966346 Enrollment ID: I20171120001705 |
| Provider Name | Lori Ann Langeland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760994289 PECOS PAC ID: 5193082246 Enrollment ID: I20171129000005 |
| Provider Name | Shaaista B Budhani |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1740569284 PECOS PAC ID: 2365741485 Enrollment ID: I20171129003459 |
| Provider Name | Hussien Farrag |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1811070923 PECOS PAC ID: 3476613431 Enrollment ID: I20180104000243 |
| Provider Name | Kelly Aten |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1497100572 PECOS PAC ID: 1153686043 Enrollment ID: I20180524000059 |
| Provider Name | Sidra Khan |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1538587050 PECOS PAC ID: 1254655640 Enrollment ID: I20180724003659 |
| Provider Name | Soohee Choi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427549427 PECOS PAC ID: 9830447010 Enrollment ID: I20180803001154 |
| Provider Name | Paul Kuder |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1114347283 PECOS PAC ID: 2668782574 Enrollment ID: I20180817002057 |
| Provider Name | Mona Patel |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1154663441 PECOS PAC ID: 9537461918 Enrollment ID: I20180828003495 |
| Provider Name | Lawrence Mark Knab |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1467786988 PECOS PAC ID: 4587962824 Enrollment ID: I20180918000990 |
| Provider Name | Jessica Spitelli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740757012 PECOS PAC ID: 7719223593 Enrollment ID: I20190116000295 |
| Provider Name | Jeong Hwan Yi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962969063 PECOS PAC ID: 2062752678 Enrollment ID: I20190319000406 |
| Provider Name | Carol Salman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1730345315 PECOS PAC ID: 4082947890 Enrollment ID: I20190611001376 |
| Provider Name | Deborah C Zoller |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1881679603 PECOS PAC ID: 6204169907 Enrollment ID: I20190612001721 |
| Provider Name | Jennifer Mallory Lynch |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1942242078 PECOS PAC ID: 2062745789 Enrollment ID: I20190612002467 |
| Provider Name | Vanessa Ramirez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841854205 PECOS PAC ID: 9133453525 Enrollment ID: I20190618002370 |
| Provider Name | Ryan Peter Bartkus |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1124318837 PECOS PAC ID: 7517187289 Enrollment ID: I20190715001207 |
| Provider Name | Janaki Nandam |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1154709731 PECOS PAC ID: 5890031173 Enrollment ID: I20190801000311 |
| Provider Name | Xixi Luo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1821485053 PECOS PAC ID: 2769792944 Enrollment ID: I20190808000075 |
| Provider Name | Shadi Eid Mohammad Hamdan |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1801088992 PECOS PAC ID: 0840430815 Enrollment ID: I20190814000033 |
| Provider Name | Jessica Edison |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1962841122 PECOS PAC ID: 2163714676 Enrollment ID: I20190911003426 |
| Provider Name | Gopi Patel |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1497160725 PECOS PAC ID: 9830410554 Enrollment ID: I20190919000037 |
| Provider Name | Alexander E Fraley |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1841385184 PECOS PAC ID: 1658432570 Enrollment ID: I20191205000878 |
| Provider Name | Danielle R Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326688714 PECOS PAC ID: 7911335815 Enrollment ID: I20200306001146 |
| Provider Name | Sharon Marie Lundberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265064927 PECOS PAC ID: 0749618551 Enrollment ID: I20200310000213 |
| Provider Name | Stephanie Munns |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1265698849 PECOS PAC ID: 8921279167 Enrollment ID: I20200402003341 |
| Provider Name | Laura Hamad |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1699186890 PECOS PAC ID: 3779878806 Enrollment ID: I20200620000091 |
| Provider Name | Amber Joy Arias Childs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740803816 PECOS PAC ID: 3072935964 Enrollment ID: I20200623001335 |
| Provider Name | Brian C Gulack |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1396036406 PECOS PAC ID: 1557787231 Enrollment ID: I20200812000676 |
| Provider Name | Sarah M Jeong |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1982015749 PECOS PAC ID: 1254557549 Enrollment ID: I20200929003634 |
| Provider Name | Kathleen Elizabeth Ready |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1033635818 PECOS PAC ID: 7416356928 Enrollment ID: I20210602002371 |
| Provider Name | Sarah E Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629654249 PECOS PAC ID: 9335543552 Enrollment ID: I20210811000152 |
| Provider Name | Amanda Elizabeth Mueller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104408418 PECOS PAC ID: 0547665572 Enrollment ID: I20210830000071 |
| Provider Name | Sameer Mehbub Kapadia |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1588007231 PECOS PAC ID: 0547673626 Enrollment ID: I20210901001177 |
| Provider Name | Megan Kosrow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972270270 PECOS PAC ID: 5092112177 Enrollment ID: I20210916003343 |
| Provider Name | Leo Jc Gabriel Pazon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972009900 PECOS PAC ID: 5991102956 Enrollment ID: I20210920000482 |
| Provider Name | Marielle Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063187615 PECOS PAC ID: 4981001690 Enrollment ID: I20210923000430 |
| Provider Name | Bo Rum Kim |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1699297796 PECOS PAC ID: 6709217573 Enrollment ID: I20211111000569 |
| Provider Name | Alexandra Wilson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1700272655 PECOS PAC ID: 0941549265 Enrollment ID: I20211208000186 |
| Provider Name | Kristen Hendrix Bishop |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1326297292 PECOS PAC ID: 7517215007 Enrollment ID: I20211228000863 |
| Provider Name | Xiangxin Hu |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1225386444 PECOS PAC ID: 8426357716 Enrollment ID: I20220120002143 |
| Provider Name | Daniel Walaszek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376295360 PECOS PAC ID: 0042603102 Enrollment ID: I20220214000498 |
| Provider Name | Niki Singh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659943090 PECOS PAC ID: 1557754413 Enrollment ID: I20220217000923 |
| Provider Name | Nicole Masse |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1720492317 PECOS PAC ID: 3577867241 Enrollment ID: I20220303001165 |
| Provider Name | Grace M Bernaldo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1770080756 PECOS PAC ID: 3274885314 Enrollment ID: I20220506000954 |
| Provider Name | Jessica Bodeman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346985959 PECOS PAC ID: 1658759055 Enrollment ID: I20220525001687 |
| Provider Name | Saira Ali Syed |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1679830293 PECOS PAC ID: 4082093257 Enrollment ID: I20220617000878 |
| Provider Name | Maria Guadalupe Aguilar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538802095 PECOS PAC ID: 2668851536 Enrollment ID: I20220623000867 |
| Provider Name | Sameera Syed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073020962 PECOS PAC ID: 6901239201 Enrollment ID: I20220630002753 |
| Provider Name | Giuseppe La Spina |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558920892 PECOS PAC ID: 5193108835 Enrollment ID: I20220813000243 |
| Provider Name | Amanda Lindsey Stone-troyner |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1508363441 PECOS PAC ID: 6103200332 Enrollment ID: I20220907001212 |
| Provider Name | Katarzyna M Walus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437879855 PECOS PAC ID: 4688040405 Enrollment ID: I20221019002938 |
| Provider Name | Rida Naheed Zahir |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386106763 PECOS PAC ID: 2062888605 Enrollment ID: I20221021001908 |
| Provider Name | Caroline Santella |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1073236584 PECOS PAC ID: 2466828074 Enrollment ID: I20221024001811 |
| Provider Name | Lauren J Lebak |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1679296743 PECOS PAC ID: 2163898560 Enrollment ID: I20221025003167 |
| Provider Name | Jasmine Jilda Ann Walker |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1326381443 PECOS PAC ID: 6406147107 Enrollment ID: I20221027000918 |
| Provider Name | Jessica Marie Szostak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164132072 PECOS PAC ID: 6608247465 Enrollment ID: I20230116000095 |
| Provider Name | Solmaz Niknam -bienia |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1316234446 PECOS PAC ID: 9436466505 Enrollment ID: I20230120001629 |
| Provider Name | Mayra Correa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487936142 PECOS PAC ID: 3375916562 Enrollment ID: I20230309001368 |
| Provider Name | Ida Bernadette Nool |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215405071 PECOS PAC ID: 6204295314 Enrollment ID: I20230707002235 |
| Provider Name | Agata A Zemla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093311813 PECOS PAC ID: 8022479526 Enrollment ID: I20230801000057 |
| Provider Name | John Tackett |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1346532124 PECOS PAC ID: 1153640172 Enrollment ID: I20230829004147 |
| Provider Name | Nicole Flores-fenlon |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1972997526 PECOS PAC ID: 5294198560 Enrollment ID: I20230905000933 |
| Provider Name | Jenna Szybowicz |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1770838450 PECOS PAC ID: 2567806094 Enrollment ID: I20240222003495 |
| Provider Name | Sehrish Jiwani |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538930946 PECOS PAC ID: 0840732996 Enrollment ID: I20240605000866 |
Davis Health Ventures Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 380 E Northwest Hwy Ste 202, Des Plaines, IL 60016 Phone: 817-503-2300 | |
Dempster Plaza Pediatrics Assoc, Ltd Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8901 Golf Rd Ste 303, Des Plaines, IL 60016 Phone: 847-297-6600 Fax: 847-297-5270 | |
Bridgecare, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2250 E Devon Ave, Suite 333, Des Plaines, IL 60018 Phone: 224-803-2273 Fax: 224-803-2274 | |
American Physician Group Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1606 Linden St, Des Plaines, IL 60018 Phone: 630-788-3115 | |
Susana C Lapid Mdsc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 380 E Northwest Hwy, 3rd Floor, Des Plaines, IL 60016 Phone: 847-296-4447 Fax: 847-398-4779 | |
Suburban Medical Center, S.c Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 380 E Northwest Hwy Ste 200, Des Plaines, IL 60016 Phone: 847-382-6870 Fax: 847-382-6083 | |
Medplus Physician Partners I, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9680 Golf Rd, 2nd Floor, Des Plaines, IL 60016 Phone: 847-699-0801 Fax: 847-296-5686 |