| Oak Street Health Physicians Group, Pc | |
|
1715 E 95th St Chicago IL 60617-4708 | |
| (773) 768-4437 | |
| (773) 564-3515 |
| Full Name | Oak Street Health Physicians Group, Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1715 E 95th St, Chicago, Illinois |
| Authorized Official Name and Position | Griffin Myers (CMO) |
| Authorized Official Contact | 3072642085 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oak Street Health Physicians Group, Pc 30 W Monroe St Ste 1200 Chicago IL 60603-2420 Ph: (312) 733-9730 | Oak Street Health Physicians Group, Pc 1715 E 95th St Chicago IL 60617-4708 Ph: (773) 768-4437 |
| NPI Number | 1083051643 |
|---|---|
| Provider Enumeration Date | 05/22/2013 |
| Last Update Date | 06/28/2023 |
| Medicare PECOS PAC ID | 7517109879 |
|---|---|
| Medicare Enrollment ID | O20130815000670 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083051643 | NPI | - | NPPES |
| Provider Name | Janice L Makela |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700833738 PECOS PAC ID: 3779496914 Enrollment ID: I20031113000146 |
| Provider Name | William H Gillard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457369662 PECOS PAC ID: 5092704536 Enrollment ID: I20040510000755 |
| Provider Name | Stephen Sproul |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427030451 PECOS PAC ID: 5991786386 Enrollment ID: I20040601000722 |
| Provider Name | Deborah Sturgis-hinton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467437558 PECOS PAC ID: 3870579279 Enrollment ID: I20040626000176 |
| Provider Name | Yatin M Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235108911 PECOS PAC ID: 1658273099 Enrollment ID: I20040629001427 |
| Provider Name | Todd M Mack |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1114039369 PECOS PAC ID: 1658358684 Enrollment ID: I20040707000559 |
| Provider Name | Mary An Maryland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093740953 PECOS PAC ID: 5092787069 Enrollment ID: I20040810000895 |
| Provider Name | Karen V Jellen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790868347 PECOS PAC ID: 8325013014 Enrollment ID: I20040826001115 |
| Provider Name | Elliott Kroger |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427087063 PECOS PAC ID: 5597732396 Enrollment ID: I20040913000264 |
| Provider Name | Lisa Dorsey Bornfreedom |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427298116 PECOS PAC ID: 6002876430 Enrollment ID: I20041012000128 |
| Provider Name | Amy L Schroeder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962512046 PECOS PAC ID: 9234193970 Enrollment ID: I20041112001010 |
| Provider Name | Denise A Bockwoldt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376505479 PECOS PAC ID: 9830157668 Enrollment ID: I20041228000175 |
| Provider Name | David Alan Brandt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629004965 PECOS PAC ID: 8628023207 Enrollment ID: I20050316000666 |
| Provider Name | Elizabeth Redell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821004466 PECOS PAC ID: 5193767739 Enrollment ID: I20050524001274 |
| Provider Name | Beatriz L Huertas Rivera |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508841982 PECOS PAC ID: 3678503315 Enrollment ID: I20050812000761 |
| Provider Name | Ashley A Keren |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1811962020 PECOS PAC ID: 6709804404 Enrollment ID: I20051110000305 |
| Provider Name | Andrea N Slasuraitis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942236393 PECOS PAC ID: 5294755807 Enrollment ID: I20051128000799 |
| Provider Name | Dharmesh Kanubhai Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619039328 PECOS PAC ID: 1456328020 Enrollment ID: I20060331000126 |
| Provider Name | Leslie A Dean |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316912462 PECOS PAC ID: 4587675533 Enrollment ID: I20060505000476 |
| Provider Name | David R Buchanan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396772992 PECOS PAC ID: 9830192830 Enrollment ID: I20060811000295 |
| Provider Name | Carlos J Aguero Medina |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053364349 PECOS PAC ID: 5698784700 Enrollment ID: I20060915000564 |
| Provider Name | Marianne Kwiatkowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750307963 PECOS PAC ID: 9638179740 Enrollment ID: I20070112000257 |
| Provider Name | Jabeen Aqueel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689883225 PECOS PAC ID: 4587764873 Enrollment ID: I20070716000605 |
| Provider Name | Deborah L Edberg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194758722 PECOS PAC ID: 8527152628 Enrollment ID: I20070920000270 |
| Provider Name | Robert J Saqueton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952325664 PECOS PAC ID: 3678669744 Enrollment ID: I20071019000638 |
| Provider Name | Joel J E Augustin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952421042 PECOS PAC ID: 9335237387 Enrollment ID: I20071108000751 |
| Provider Name | Kyra A Payne |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1487864542 PECOS PAC ID: 9133203581 Enrollment ID: I20080225000538 |
| Provider Name | Natalya Vladimirskiy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326246356 PECOS PAC ID: 7315012317 Enrollment ID: I20080826000114 |
| Provider Name | Humaira Khan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811174105 PECOS PAC ID: 0941368120 Enrollment ID: I20081016000070 |
| Provider Name | Theodore Christou |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235106022 PECOS PAC ID: 9436127156 Enrollment ID: I20090522000054 |
| Provider Name | William Sandoval |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912080912 PECOS PAC ID: 6406908334 Enrollment ID: I20090723000334 |
| Provider Name | Rajesh Kumar Sharma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407881964 PECOS PAC ID: 1951443860 Enrollment ID: I20100114000774 |
| Provider Name | Lea Q Lisowski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669687315 PECOS PAC ID: 6800938762 Enrollment ID: I20100115000417 |
| Provider Name | Elizabeth Nodine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346449527 PECOS PAC ID: 6507991759 Enrollment ID: I20100312001026 |
| Provider Name | Paramjit Sikand |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902875628 PECOS PAC ID: 2860529104 Enrollment ID: I20100419000680 |
| Provider Name | Ashir Wahab |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376591958 PECOS PAC ID: 2062303274 Enrollment ID: I20100610000060 |
| Provider Name | Mark E Pappadopoli |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821183781 PECOS PAC ID: 2062545437 Enrollment ID: I20100805000507 |
| Provider Name | Diane Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992953152 PECOS PAC ID: 1254465875 Enrollment ID: I20100818000935 |
| Provider Name | Julie R Blankemeier |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801101555 PECOS PAC ID: 4082730197 Enrollment ID: I20100927000705 |
| Provider Name | Kevin P Malone |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1003082488 PECOS PAC ID: 7214002310 Enrollment ID: I20101007000277 |
| Provider Name | Cynthia Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265749972 PECOS PAC ID: 5092908590 Enrollment ID: I20101015001119 |
| Provider Name | Muhammad Ahmed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487848453 PECOS PAC ID: 7810181310 Enrollment ID: I20101028000933 |
| Provider Name | Rusalina Muntean Mincu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295782431 PECOS PAC ID: 4486603610 Enrollment ID: I20110117000153 |
| Provider Name | Sameer S Jain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699987230 PECOS PAC ID: 0244383404 Enrollment ID: I20110211000889 |
| Provider Name | Susan C Winterbauer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073816013 PECOS PAC ID: 9638350101 Enrollment ID: I20110217000245 |
| Provider Name | Sherie D Marshall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306176862 PECOS PAC ID: 9931380110 Enrollment ID: I20110221001021 |
| Provider Name | Kevin Julius Barrett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801112420 PECOS PAC ID: 1456532274 Enrollment ID: I20110225000625 |
| Provider Name | Sergio Rodriguez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588705230 PECOS PAC ID: 4880875566 Enrollment ID: I20110301000558 |
| Provider Name | Alfred J Martin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386764090 PECOS PAC ID: 2961684162 Enrollment ID: I20110309000616 |
| Provider Name | Deepa Potti |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144206301 PECOS PAC ID: 4486629375 Enrollment ID: I20110614000556 |
| Provider Name | Angelina D Ledonne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407977838 PECOS PAC ID: 6305024365 Enrollment ID: I20110623000024 |
| Provider Name | Thirath Chau |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285896720 PECOS PAC ID: 4789854423 Enrollment ID: I20110907000982 |
| Provider Name | Christabelle Andrea Cabanilla |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447412366 PECOS PAC ID: 7214108471 Enrollment ID: I20110919000795 |
| Provider Name | Priscilla Rivera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205116282 PECOS PAC ID: 8527230325 Enrollment ID: I20111019000782 |
| Provider Name | Sandra Pinilla |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013172139 PECOS PAC ID: 5193990018 Enrollment ID: I20111205000498 |
| Provider Name | Mark S Stolspart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437428786 PECOS PAC ID: 2961669429 Enrollment ID: I20120210000565 |
| Provider Name | Daniel Novella |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366670846 PECOS PAC ID: 0547426447 Enrollment ID: I20120720000535 |
| Provider Name | Joanna L Kmiecik |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508173329 PECOS PAC ID: 0648427401 Enrollment ID: I20120829000714 |
| Provider Name | Kelley O Holloway Marshall |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1942593231 PECOS PAC ID: 6608026166 Enrollment ID: I20121019000037 |
| Provider Name | Jean E Reidy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811248750 PECOS PAC ID: 0143475384 Enrollment ID: I20130219000527 |
| Provider Name | Emily Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437403755 PECOS PAC ID: 9032354949 Enrollment ID: I20130326000056 |
| Provider Name | Andrea Khosropour |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689802340 PECOS PAC ID: 3072758770 Enrollment ID: I20130401000103 |
| Provider Name | Niraj Y Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215248067 PECOS PAC ID: 6103068036 Enrollment ID: I20130806000401 |
| Provider Name | Griffin Myers |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1871817643 PECOS PAC ID: 7719145127 Enrollment ID: I20130815000938 |
| Provider Name | Katherine M Suberlak |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811125412 PECOS PAC ID: 2365678737 Enrollment ID: I20131114000409 |
| Provider Name | Jill N Degen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811292717 PECOS PAC ID: 2264660521 Enrollment ID: I20140113000171 |
| Provider Name | Gretel Ruiz Jorge |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1427289859 PECOS PAC ID: 4789813254 Enrollment ID: I20140203000366 |
| Provider Name | Rebecca Murray |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134557473 PECOS PAC ID: 2365675451 Enrollment ID: I20140424001814 |
| Provider Name | Toi Juana R Murray |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275764730 PECOS PAC ID: 2062636798 Enrollment ID: I20140618002195 |
| Provider Name | Jamal R Ross |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205156429 PECOS PAC ID: 9739304791 Enrollment ID: I20140707001101 |
| Provider Name | Francina M Peralta Machado |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508181108 PECOS PAC ID: 0446476899 Enrollment ID: I20140722000473 |
| Provider Name | Barbara J Hardt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811307614 PECOS PAC ID: 0941426621 Enrollment ID: I20140801001902 |
| Provider Name | Brian Luc |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376833657 PECOS PAC ID: 9234352014 Enrollment ID: I20140811001577 |
| Provider Name | Prerak Shah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902032014 PECOS PAC ID: 2961648373 Enrollment ID: I20141015000607 |
| Provider Name | Nicole Owens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811305758 PECOS PAC ID: 9739301953 Enrollment ID: I20141103002302 |
| Provider Name | Mayra Gonzalez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548550262 PECOS PAC ID: 4284856378 Enrollment ID: I20141105000014 |
| Provider Name | Diana Guillaume |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396037685 PECOS PAC ID: 0042532806 Enrollment ID: I20141204002482 |
| Provider Name | Marta H Sciubisz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922394808 PECOS PAC ID: 9739402637 Enrollment ID: I20141230000401 |
| Provider Name | Carolyn A Read |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942605886 PECOS PAC ID: 4789908815 Enrollment ID: I20150121000855 |
| Provider Name | Tina Valdez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780905349 PECOS PAC ID: 6507096443 Enrollment ID: I20150218000749 |
| Provider Name | Vanessa E Ortiz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205234879 PECOS PAC ID: 2264758739 Enrollment ID: I20150226001810 |
| Provider Name | Danbee K Kwon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932536703 PECOS PAC ID: 6305069287 Enrollment ID: I20150504002020 |
| Provider Name | Yung Sim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013203686 PECOS PAC ID: 5496076283 Enrollment ID: I20150604002563 |
| Provider Name | Rebecca Ann Levine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841553294 PECOS PAC ID: 8820309941 Enrollment ID: I20150616002190 |
| Provider Name | Adrianna K Chauncey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578852562 PECOS PAC ID: 8022329861 Enrollment ID: I20150619000572 |
| Provider Name | Palav Jitendra Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588928287 PECOS PAC ID: 6800107244 Enrollment ID: I20150625001795 |
| Provider Name | Charlotte Allen O'brien |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902123938 PECOS PAC ID: 6002945961 Enrollment ID: I20150630000383 |
| Provider Name | Deborah L Walsh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346646213 PECOS PAC ID: 2769794767 Enrollment ID: I20150706000718 |
| Provider Name | Michelle Lee Morrison |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508120783 PECOS PAC ID: 5496067910 Enrollment ID: I20150710002328 |
| Provider Name | Eric Tuason Aguinaldo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720374002 PECOS PAC ID: 0345553293 Enrollment ID: I20150721001475 |
| Provider Name | Ashley Chou |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033409297 PECOS PAC ID: 9234376054 Enrollment ID: I20150831002841 |
| Provider Name | Mira Desai |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538559190 PECOS PAC ID: 6800104787 Enrollment ID: I20150925000574 |
| Provider Name | Ashton N Forsythe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942677984 PECOS PAC ID: 8921316365 Enrollment ID: I20151005000359 |
| Provider Name | Amish H Desai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215202429 PECOS PAC ID: 1951610054 Enrollment ID: I20151012000522 |
| Provider Name | Abiah A Grant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720488760 PECOS PAC ID: 5395068043 Enrollment ID: I20151201000414 |
| Provider Name | Diana Simmons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962872622 PECOS PAC ID: 7719288869 Enrollment ID: I20151215002872 |
| Provider Name | Dawn M Tornow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336512532 PECOS PAC ID: 4486955481 Enrollment ID: I20151216001947 |
| Provider Name | Ausra Simmert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386009686 PECOS PAC ID: 1658673215 Enrollment ID: I20160113002463 |
| Provider Name | Natalia Klusacek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497142285 PECOS PAC ID: 1759686660 Enrollment ID: I20160301001378 |
| Provider Name | Jamilah F Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154796605 PECOS PAC ID: 7113223769 Enrollment ID: I20160309000240 |
| Provider Name | Vanessa R Sohn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891135059 PECOS PAC ID: 1153610274 Enrollment ID: I20160512002114 |
| Provider Name | Andrea Zajac |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154786705 PECOS PAC ID: 9830492578 Enrollment ID: I20160929001956 |
| Provider Name | Laurie C Peercy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003365842 PECOS PAC ID: 3577851930 Enrollment ID: I20161018001267 |
| Provider Name | Lesbia Rodriguez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861735508 PECOS PAC ID: 8325340250 Enrollment ID: I20161019002276 |
| Provider Name | Leshaun Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043679681 PECOS PAC ID: 0941580823 Enrollment ID: I20161212000651 |
| Provider Name | Jorel O Martinez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336553684 PECOS PAC ID: 7618271131 Enrollment ID: I20170105000543 |
| Provider Name | Luis L Rivera |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619396371 PECOS PAC ID: 6901187996 Enrollment ID: I20170105002316 |
| Provider Name | Julie A Worley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285613059 PECOS PAC ID: 5395787261 Enrollment ID: I20170124000524 |
| Provider Name | Gioconda Arias |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558806539 PECOS PAC ID: 8224310404 Enrollment ID: I20170124000536 |
| Provider Name | Shamecka N Edwards |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497098289 PECOS PAC ID: 6002118007 Enrollment ID: I20170131000345 |
| Provider Name | Cindy Suthar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750815981 PECOS PAC ID: 6204113194 Enrollment ID: I20170502001360 |
| Provider Name | Cindy Valencia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992259410 PECOS PAC ID: 1153585849 Enrollment ID: I20170505000200 |
| Provider Name | British Hughes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053834259 PECOS PAC ID: 3072884063 Enrollment ID: I20170809003593 |
| Provider Name | Lijun He |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619300977 PECOS PAC ID: 2668608589 Enrollment ID: I20170906000022 |
| Provider Name | Marisa Reyes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568997369 PECOS PAC ID: 4486927670 Enrollment ID: I20170911001293 |
| Provider Name | Avani Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487170213 PECOS PAC ID: 0547534562 Enrollment ID: I20170914001590 |
| Provider Name | Jennifer Danielle Mainor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467979260 PECOS PAC ID: 5991079899 Enrollment ID: I20170915001121 |
| Provider Name | Elizabeth Boone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235517954 PECOS PAC ID: 1355617515 Enrollment ID: I20171017000580 |
| Provider Name | Jessika Epperson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487171328 PECOS PAC ID: 0345516225 Enrollment ID: I20171019003222 |
| Provider Name | Gabriela Amaro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255859534 PECOS PAC ID: 9931475548 Enrollment ID: I20171026002242 |
| Provider Name | Dinora Flores |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073024501 PECOS PAC ID: 4183981285 Enrollment ID: I20171128001339 |
| Provider Name | Emily K Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811415342 PECOS PAC ID: 1850658832 Enrollment ID: I20171129001899 |
| Provider Name | Dana Sebek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992214373 PECOS PAC ID: 7810254836 Enrollment ID: I20171129003588 |
| Provider Name | Erica Minnion-klyce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205340080 PECOS PAC ID: 3072872522 Enrollment ID: I20180109002120 |
| Provider Name | Dymond Denee Long |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114463049 PECOS PAC ID: 3173807625 Enrollment ID: I20180112000180 |
| Provider Name | Shelane Solt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134634488 PECOS PAC ID: 3274894092 Enrollment ID: I20180219000843 |
| Provider Name | Elizabeth Bolanos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518465632 PECOS PAC ID: 0547521676 Enrollment ID: I20180306000030 |
| Provider Name | Silvia Nunez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598272023 PECOS PAC ID: 4486918208 Enrollment ID: I20180503000001 |
| Provider Name | Patricia Galvez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740788009 PECOS PAC ID: 6901161199 Enrollment ID: I20180517000058 |
| Provider Name | Emily Cofsky Matthews |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922504349 PECOS PAC ID: 6305101536 Enrollment ID: I20180517001768 |
| Provider Name | Laura Trujillo-castellanos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588155956 PECOS PAC ID: 6709131907 Enrollment ID: I20180612000384 |
| Provider Name | John Thomas Matera |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1770970931 PECOS PAC ID: 8325341944 Enrollment ID: I20180613003235 |
| Provider Name | Babatunde Ogundipe |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497911267 PECOS PAC ID: 7315292331 Enrollment ID: I20180628002908 |
| Provider Name | Jennifer Denise Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467946517 PECOS PAC ID: 3476809906 Enrollment ID: I20180712003241 |
| Provider Name | Neha Sakhuja |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821584756 PECOS PAC ID: 5294082871 Enrollment ID: I20180728000000 |
| Provider Name | Steven Wei Song |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538540984 PECOS PAC ID: 6800198201 Enrollment ID: I20180802002111 |
| Provider Name | Berlinda Torres |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477709277 PECOS PAC ID: 0042569204 Enrollment ID: I20180821002270 |
| Provider Name | Kevin Stephens |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770977662 PECOS PAC ID: 0840504296 Enrollment ID: I20180827002046 |
| Provider Name | Reem Jamal Mohammad |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1407268378 PECOS PAC ID: 0648579839 Enrollment ID: I20180901000126 |
| Provider Name | Kynyahta L Walters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255810966 PECOS PAC ID: 7416207626 Enrollment ID: I20180910002456 |
| Provider Name | Holly M Krawza |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033645395 PECOS PAC ID: 6204189764 Enrollment ID: I20181030002780 |
| Provider Name | Claudia Navarrete |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861807562 PECOS PAC ID: 5395099477 Enrollment ID: I20181107002933 |
| Provider Name | Maliha S Khan |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1790165959 PECOS PAC ID: 3577877802 Enrollment ID: I20181112002186 |
| Provider Name | Luis Alfredo Lopez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760895395 PECOS PAC ID: 6103195078 Enrollment ID: I20181214001471 |
| Provider Name | Ali Khan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1710202999 PECOS PAC ID: 7810137718 Enrollment ID: I20181231000284 |
| Provider Name | Naomi Shirleen Chinavong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487118550 PECOS PAC ID: 2365780434 Enrollment ID: I20190214002725 |
| Provider Name | Shivani A Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164831251 PECOS PAC ID: 8527364181 Enrollment ID: I20190215001766 |
| Provider Name | Jovana Simovic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912418484 PECOS PAC ID: 0840532230 Enrollment ID: I20190506000918 |
| Provider Name | Zeba S Geloo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730255977 PECOS PAC ID: 8224062286 Enrollment ID: I20190529001120 |
| Provider Name | Abiodun Josephine Atomori |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063071819 PECOS PAC ID: 0547593964 Enrollment ID: I20190617002366 |
| Provider Name | Gianna Noelle Martelli |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013574656 PECOS PAC ID: 9638402068 Enrollment ID: I20190617002845 |
| Provider Name | Nancy Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417513813 PECOS PAC ID: 9638402027 Enrollment ID: I20190618002094 |
| Provider Name | Deidra Sanford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386106649 PECOS PAC ID: 8921332305 Enrollment ID: I20190619002451 |
| Provider Name | Janey Eden Kottler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316506082 PECOS PAC ID: 2365776465 Enrollment ID: I20190624002054 |
| Provider Name | Chloe Ciccariello |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710373204 PECOS PAC ID: 2264705920 Enrollment ID: I20190815000102 |
| Provider Name | Tenisha Shawan Mccaskill |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659729663 PECOS PAC ID: 3274820006 Enrollment ID: I20190830000304 |
| Provider Name | Margaret A Clemons Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023661980 PECOS PAC ID: 9335478171 Enrollment ID: I20190904002268 |
| Provider Name | Neerja S Joshi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306292412 PECOS PAC ID: 5698062784 Enrollment ID: I20190917002830 |
| Provider Name | Nakia Monique Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508425083 PECOS PAC ID: 4688905631 Enrollment ID: I20191007001054 |
| Provider Name | Erica Navarro |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568001337 PECOS PAC ID: 7618302142 Enrollment ID: I20200110001188 |
| Provider Name | Amanda E Wright |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033505045 PECOS PAC ID: 5092087643 Enrollment ID: I20200113001088 |
| Provider Name | Judith Ann Mrvan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962649335 PECOS PAC ID: 6507161684 Enrollment ID: I20200311001850 |
| Provider Name | Anna Burcenski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821636879 PECOS PAC ID: 8022446269 Enrollment ID: I20200321000058 |
| Provider Name | Doris Fandohan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679038186 PECOS PAC ID: 1557603974 Enrollment ID: I20200501000028 |
| Provider Name | Alissa Haight |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508342874 PECOS PAC ID: 5496185662 Enrollment ID: I20200501000313 |
| Provider Name | Patricia Jazmin Martinez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427687524 PECOS PAC ID: 7810328689 Enrollment ID: I20200511002491 |
| Provider Name | Hilda Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669841508 PECOS PAC ID: 0042528192 Enrollment ID: I20200722003994 |
| Provider Name | Michael Duarte |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306379268 PECOS PAC ID: 1456785039 Enrollment ID: I20200819000767 |
| Provider Name | James Hodges |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1659620029 PECOS PAC ID: 5395965636 Enrollment ID: I20200819001523 |
| Provider Name | Hebah Arroyo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265951792 PECOS PAC ID: 1557787637 Enrollment ID: I20200819003760 |
| Provider Name | Palak Shah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598292799 PECOS PAC ID: 5395161210 Enrollment ID: I20200821001550 |
| Provider Name | Patrick Jeffery Hines |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023549821 PECOS PAC ID: 0547530396 Enrollment ID: I20200828002667 |
| Provider Name | Unnati Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952838179 PECOS PAC ID: 9436577178 Enrollment ID: I20200914000681 |
| Provider Name | Maggie Spleet |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093064701 PECOS PAC ID: 9335567981 Enrollment ID: I20200914001107 |
| Provider Name | Margaux Dechambre |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427589134 PECOS PAC ID: 7214208982 Enrollment ID: I20200917001075 |
| Provider Name | Christopher Than |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477947844 PECOS PAC ID: 1850637323 Enrollment ID: I20201027000342 |
| Provider Name | Mutengwana Kasapu-mwaba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619480696 PECOS PAC ID: 7618214503 Enrollment ID: I20201029000226 |
| Provider Name | Justin Hunt |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326138074 PECOS PAC ID: 6901842228 Enrollment ID: I20210128000438 |
| Provider Name | Joyce Fricks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174900450 PECOS PAC ID: 1951716331 Enrollment ID: I20210217000664 |
| Provider Name | Emily Leos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215537790 PECOS PAC ID: 2466867858 Enrollment ID: I20210217000842 |
| Provider Name | Monica Figueroa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417556812 PECOS PAC ID: 7810302106 Enrollment ID: I20210218002284 |
| Provider Name | Rochelle A Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104416163 PECOS PAC ID: 6305252990 Enrollment ID: I20210305000817 |
| Provider Name | April Gallik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134720436 PECOS PAC ID: 7315354446 Enrollment ID: I20210407002002 |
| Provider Name | Rachel Sabb |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629321096 PECOS PAC ID: 0547412371 Enrollment ID: I20210415000079 |
| Provider Name | Ashley Elise Cohen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689269698 PECOS PAC ID: 5597173815 Enrollment ID: I20210426001116 |
| Provider Name | Agnieszka Glowik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942820014 PECOS PAC ID: 7416365770 Enrollment ID: I20210427000024 |
| Provider Name | Gerald Santangelo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578127684 PECOS PAC ID: 9638579824 Enrollment ID: I20210609001689 |
| Provider Name | Michelle Woo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942690243 PECOS PAC ID: 2466778063 Enrollment ID: I20210709002021 |
| Provider Name | Marie Danielle Jena Rud |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235622432 PECOS PAC ID: 4880939263 Enrollment ID: I20210723000148 |
| Provider Name | Kelly A Quaine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609499060 PECOS PAC ID: 5193128098 Enrollment ID: I20210729003584 |
| Provider Name | Darrian Renee Sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073147989 PECOS PAC ID: 5597031500 Enrollment ID: I20210813000652 |
| Provider Name | Rupen Amin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376709493 PECOS PAC ID: 9234313933 Enrollment ID: I20210813002588 |
| Provider Name | Heriberto Rodriguez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811480908 PECOS PAC ID: 6800291386 Enrollment ID: I20210820002520 |
| Provider Name | Marco Palomo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174029284 PECOS PAC ID: 8325443310 Enrollment ID: I20210830002244 |
| Provider Name | Juerita White |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679247936 PECOS PAC ID: 4183020811 Enrollment ID: I20210907000020 |
| Provider Name | Jordan R Keller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386318947 PECOS PAC ID: 7911305099 Enrollment ID: I20211004001450 |
| Provider Name | Forrest Yeakley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841787611 PECOS PAC ID: 7911305842 Enrollment ID: I20211007001509 |
| Provider Name | Adib Rushdan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932692746 PECOS PAC ID: 8527309301 Enrollment ID: I20211007001727 |
| Provider Name | Bagum Karimullah Gulshad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154963544 PECOS PAC ID: 9931533270 Enrollment ID: I20211011001954 |
| Provider Name | Sarah Torregiani |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1891774980 PECOS PAC ID: 0840231452 Enrollment ID: I20211013003717 |
| Provider Name | Gabrielle Garzony |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952926495 PECOS PAC ID: 5496174039 Enrollment ID: I20211027002098 |
| Provider Name | Vanessa K Bajaj |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316546641 PECOS PAC ID: 2769870492 Enrollment ID: I20211028001612 |
| Provider Name | Anwar Jebran |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205356821 PECOS PAC ID: 6608148226 Enrollment ID: I20211104002776 |
| Provider Name | Timanika Dansby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083016547 PECOS PAC ID: 5698061299 Enrollment ID: I20211106000212 |
| Provider Name | Amanda Keenan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457014086 PECOS PAC ID: 9133519655 Enrollment ID: I20211124000033 |
| Provider Name | Juanita Hofman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871257014 PECOS PAC ID: 9739579269 Enrollment ID: I20211124000252 |
| Provider Name | Gabrielle Czaja |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154087880 PECOS PAC ID: 9133519044 Enrollment ID: I20211208003113 |
| Provider Name | Irene Drabysheuskaya |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073284907 PECOS PAC ID: 8325439631 Enrollment ID: I20211221002196 |
| Provider Name | Melissa Leniece Oliver |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073270989 PECOS PAC ID: 4587055694 Enrollment ID: I20211228002154 |
| Provider Name | Christiana S. Shoushtari |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265938906 PECOS PAC ID: 6305238189 Enrollment ID: I20220128001225 |
| Provider Name | Tanvi Kadakia |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1891289765 PECOS PAC ID: 3476809559 Enrollment ID: I20220209002134 |
| Provider Name | Elizabeth A Kislov |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508524174 PECOS PAC ID: 6901291780 Enrollment ID: I20220314000596 |
| Provider Name | Jodi M Roque |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346478526 PECOS PAC ID: 8022265768 Enrollment ID: I20220315001300 |
| Provider Name | Sully Vega |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699434266 PECOS PAC ID: 2264827716 Enrollment ID: I20220318001027 |
| Provider Name | Laura S Tse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467951483 PECOS PAC ID: 5193087708 Enrollment ID: I20220329000715 |
| Provider Name | Heather Duncan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952858813 PECOS PAC ID: 4082997739 Enrollment ID: I20220408001156 |
| Provider Name | Ana K Gilman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093331837 PECOS PAC ID: 3173919503 Enrollment ID: I20220411002012 |
| Provider Name | Sheila Lynn Riffe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104420751 PECOS PAC ID: 4880007962 Enrollment ID: I20220412001146 |
| Provider Name | Rene Roberts |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073894283 PECOS PAC ID: 1557688603 Enrollment ID: I20220426001135 |
| Provider Name | Dorothy Jakubowski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588299705 PECOS PAC ID: 9739576547 Enrollment ID: I20220426001977 |
| Provider Name | Olufunke Grace Ajifolokun |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922600873 PECOS PAC ID: 7315334893 Enrollment ID: I20220502001538 |
| Provider Name | Carol Sacco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609265149 PECOS PAC ID: 2668797762 Enrollment ID: I20220506001948 |
| Provider Name | Alexandra Beris |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174520050 PECOS PAC ID: 2567455801 Enrollment ID: I20220511000405 |
| Provider Name | Carolina Diaz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558005389 PECOS PAC ID: 7618355405 Enrollment ID: I20220607002454 |
| Provider Name | Michele Mitchell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174505325 PECOS PAC ID: 9234215401 Enrollment ID: I20220730000421 |
| Provider Name | Michael Y Chen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861954695 PECOS PAC ID: 3577899798 Enrollment ID: I20220804002547 |
| Provider Name | Cynthia Cazares |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154067858 PECOS PAC ID: 5294117347 Enrollment ID: I20220805000692 |
| Provider Name | Jessie Wayne Castro |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144614454 PECOS PAC ID: 0143603274 Enrollment ID: I20220822003275 |
| Provider Name | Laura Kaufman Minardi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710337977 PECOS PAC ID: 2769776277 Enrollment ID: I20220823001767 |
| Provider Name | Sean Llewellyn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215499975 PECOS PAC ID: 7214279280 Enrollment ID: I20220830002007 |
| Provider Name | Frances Rivera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326711359 PECOS PAC ID: 2961886585 Enrollment ID: I20220831002143 |
| Provider Name | Richie Torres |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639801533 PECOS PAC ID: 7012392020 Enrollment ID: I20220912001957 |
| Provider Name | Jean Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518242064 PECOS PAC ID: 1557528817 Enrollment ID: I20221004001167 |
| Provider Name | Lisa Ryan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710207444 PECOS PAC ID: 0244464725 Enrollment ID: I20221005002253 |
| Provider Name | Rachel Hildebrand |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528531258 PECOS PAC ID: 7416299748 Enrollment ID: I20221018003087 |
| Provider Name | Marjorie Remy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164151171 PECOS PAC ID: 8325415995 Enrollment ID: I20221110002870 |
| Provider Name | Melissa A Clark |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982054862 PECOS PAC ID: 6800264110 Enrollment ID: I20221117001414 |
| Provider Name | Ivonne Pino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356802730 PECOS PAC ID: 7911376801 Enrollment ID: I20221215002967 |
| Provider Name | Kathleen Anne O'rourke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790374973 PECOS PAC ID: 3274904586 Enrollment ID: I20230125000616 |
| Provider Name | Tenilya S Mumphus |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255086641 PECOS PAC ID: 0244602365 Enrollment ID: I20230217000892 |
| Provider Name | Lindsay Chrzanowski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003566258 PECOS PAC ID: 0143603209 Enrollment ID: I20230331001827 |
| Provider Name | Rebecca Gloria Bernardi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164129458 PECOS PAC ID: 6507221512 Enrollment ID: I20230426002741 |
| Provider Name | Tina Morrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730703695 PECOS PAC ID: 8123448669 Enrollment ID: I20230508001940 |
| Provider Name | Clementina Verdin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760178909 PECOS PAC ID: 6709241169 Enrollment ID: I20230508002825 |
| Provider Name | Paige Scholer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154827806 PECOS PAC ID: 2860805413 Enrollment ID: I20230621002952 |
| Provider Name | Jennifer Noonan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386645331 PECOS PAC ID: 8123087434 Enrollment ID: I20230704000399 |
| Provider Name | Zue Head |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275034753 PECOS PAC ID: 2062773344 Enrollment ID: I20230726000486 |
| Provider Name | Candace Stone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467100149 PECOS PAC ID: 7517348899 Enrollment ID: I20230727001065 |
| Provider Name | Beverly Onyekwuluje |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235594375 PECOS PAC ID: 2668834904 Enrollment ID: I20230817002636 |
| Provider Name | Melissa Chiang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609339159 PECOS PAC ID: 3577896968 Enrollment ID: I20230818000140 |
| Provider Name | Oludara Olutomi Talabi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023646494 PECOS PAC ID: 0446613517 Enrollment ID: I20230823001909 |
| Provider Name | Sheby Elsa Jacob |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407535826 PECOS PAC ID: 3971966714 Enrollment ID: I20230828001883 |
| Provider Name | Beata Barbara Binski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285318048 PECOS PAC ID: 7012370786 Enrollment ID: I20230829000042 |
| Provider Name | Hee Chong Jennifer Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609405653 PECOS PAC ID: 3678984036 Enrollment ID: I20230830001624 |
| Provider Name | Anita Vasudevan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215556097 PECOS PAC ID: 4981028396 Enrollment ID: I20230908001606 |
| Provider Name | Keirsten Michelle Reilly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750903654 PECOS PAC ID: 7315361706 Enrollment ID: I20230914002044 |
| Provider Name | Justyna E Pomiotlo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629475546 PECOS PAC ID: 5698094621 Enrollment ID: I20230914003565 |
| Provider Name | Janee S Ware |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952692816 PECOS PAC ID: 4981921038 Enrollment ID: I20231005001943 |
| Provider Name | Shweta Agarwal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982382511 PECOS PAC ID: 7810342102 Enrollment ID: I20231005002485 |
| Provider Name | Rebecca Ilene Stern |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467913855 PECOS PAC ID: 9133456742 Enrollment ID: I20231023000682 |
| Provider Name | Erika Balbuena |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326724881 PECOS PAC ID: 6305292533 Enrollment ID: I20231025000323 |
| Provider Name | Shira Lerner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609226869 PECOS PAC ID: 5294029708 Enrollment ID: I20231027002580 |
| Provider Name | Pooja Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518481845 PECOS PAC ID: 1557603388 Enrollment ID: I20231030001277 |
| Provider Name | Nayely Cortes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548947526 PECOS PAC ID: 4587010178 Enrollment ID: I20231102002907 |
| Provider Name | Amarilis Diaz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356975692 PECOS PAC ID: 9931552494 Enrollment ID: I20240131003023 |
| Provider Name | Francisco Lopez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609140060 PECOS PAC ID: 5799120457 Enrollment ID: I20240304003110 |
| Provider Name | Jessica Jurado |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821853805 PECOS PAC ID: 8729424965 Enrollment ID: I20240311003202 |
| Provider Name | Barbara Tapps |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316158900 PECOS PAC ID: 3274694419 Enrollment ID: I20240312002821 |
| Provider Name | Marcos Erazo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033894530 PECOS PAC ID: 6709223068 Enrollment ID: I20240321002758 |
| Provider Name | Shazia Shivji |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639681018 PECOS PAC ID: 0648690784 Enrollment ID: I20240328002148 |
| Provider Name | Yuly X Rebollar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740048354 PECOS PAC ID: 1658719489 Enrollment ID: I20240329000678 |
| Provider Name | Patricia Gomez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093428955 PECOS PAC ID: 4284073396 Enrollment ID: I20240422001491 |
| Provider Name | Cassandra Pax |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1487373809 PECOS PAC ID: 7719326727 Enrollment ID: I20240423002186 |
| Provider Name | Wendee Anderson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245847722 PECOS PAC ID: 3375941446 Enrollment ID: I20240429002331 |
| Provider Name | Kelley Nicole Larson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023764263 PECOS PAC ID: 3971045162 Enrollment ID: I20240603003354 |
Pilsen Pediatrics Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1952 W Cermak Rd, Chicago, IL 60608 Phone: 773-254-6611 Fax: 773-254-8590 | |
A Kavaliunas Md Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5540 S Pulaski Rd, Chicago, IL 60629 Phone: 773-585-2802 | |
Doc Cam Medical Center Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2315 E 93rd St Ste 337, Chicago, IL 60617 Phone: 773-731-2700 Fax: 773-373-1868 | |
Excellent Eye Care Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5352 N Milwaukee Ave, Chicago, IL 60630 Phone: 773-777-7444 Fax: 773-775-4030 | |
Pediatric General Care & Research Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4527 N Pulaski Rd, Chicago, IL 60630 Phone: 773-267-7060 Fax: 773-267-4752 | |
Urban Family Health Center Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10830 S Halsted St, Chicago, IL 60628 Phone: 773-264-1400 Fax: 773-264-1401 | |
Premier Primary Care And Alternative Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1301 E 47th Street, Bldg 2 Suite B, Chicago, IL 60653 Phone: 773-891-2890 Fax: 773-891-4107 |