| Presence Medical Group | |
|
2380 E Dempster St Des Plaines IL 60016-4839 | |
| (833) 291-0464 | |
| Not Available |
| Full Name | Presence Medical Group |
|---|---|
| Speciality | Clinic/Center |
| Location | 2380 E Dempster St, Des Plaines, Illinois |
| Authorized Official Name and Position | Reinhold Llerena (PRESIDENT) |
| Authorized Official Contact | 8332910464 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Presence Medical Group 2380 E Dempster St Des Plaines IL 60016-4839 Ph: (833) 291-0464 | Presence Medical Group 2380 E Dempster St Des Plaines IL 60016-4839 Ph: (833) 291-0464 |
| NPI Number | 1356727127 |
|---|---|
| Provider Enumeration Date | 08/04/2015 |
| Last Update Date | 05/30/2024 |
| Medicare PECOS PAC ID | 2860396769 |
|---|---|
| Medicare Enrollment ID | O20150810001673 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356727127 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Stathis J Poulakidas |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1508833344 PECOS PAC ID: 9537067608 Enrollment ID: I20031229000098 |
| Provider Name | Maria Elena Iliescu |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1235131046 PECOS PAC ID: 4183517436 Enrollment ID: I20040203000025 |
| Provider Name | Joseph Rosman |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1760478754 PECOS PAC ID: 0648167940 Enrollment ID: I20040302000421 |
| Provider Name | Suresh H Wadhwani |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1659406510 PECOS PAC ID: 7315836897 Enrollment ID: I20040313000705 |
| Provider Name | Erik Borncamp |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1689647661 PECOS PAC ID: 1153212691 Enrollment ID: I20040323001293 |
| Provider Name | Manoj Duggal |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1447243258 PECOS PAC ID: 0446245500 Enrollment ID: I20040417000467 |
| Provider Name | Robert W Schubert |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245236363 PECOS PAC ID: 4688669922 Enrollment ID: I20040421000717 |
| Provider Name | Valerie Goldfain |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1619962941 PECOS PAC ID: 9436147600 Enrollment ID: I20040505000879 |
| Provider Name | Roger L Taylor |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1841285301 PECOS PAC ID: 5395730279 Enrollment ID: I20040505001124 |
| Provider Name | Kevin E Gordon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811082431 PECOS PAC ID: 8022008549 Enrollment ID: I20040517000554 |
| 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 | Mario G Massullo |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1043228158 PECOS PAC ID: 3577554690 Enrollment ID: I20040519000182 |
| Provider Name | Rebecca Ellen Veasey |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1700832326 PECOS PAC ID: 6608867478 Enrollment ID: I20040520000613 |
| Provider Name | Ming Xu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548271018 PECOS PAC ID: 4981687431 Enrollment ID: I20040608000281 |
| Provider Name | Abraham Thomas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063423655 PECOS PAC ID: 0840277307 Enrollment ID: I20040701001411 |
| Provider Name | Fadi Habib |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1013963164 PECOS PAC ID: 0749252591 Enrollment ID: I20040811000906 |
| Provider Name | Ismail A Bobat |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1750310553 PECOS PAC ID: 7416942552 Enrollment ID: I20040817001035 |
| Provider Name | Oksana Shulzhenko |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1477512838 PECOS PAC ID: 2264406784 Enrollment ID: I20040820001118 |
| Provider Name | Rhodora A Sy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710085535 PECOS PAC ID: 6002885621 Enrollment ID: I20040930000480 |
| Provider Name | Sajit Bux |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1467488957 PECOS PAC ID: 5597725887 Enrollment ID: I20041012000651 |
| Provider Name | Vincent R Benig |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487609772 PECOS PAC ID: 4183684657 Enrollment ID: I20041019000376 |
| Provider Name | Tamir Hersonskey |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1629025663 PECOS PAC ID: 4183686637 Enrollment ID: I20041028000055 |
| Provider Name | Aqeel Khan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629046735 PECOS PAC ID: 3678535457 Enrollment ID: I20041104000952 |
| Provider Name | Yousuf Z Mohammed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386615607 PECOS PAC ID: 7214990886 Enrollment ID: I20041105000231 |
| Provider Name | Jordan A Goodman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538244389 PECOS PAC ID: 9931162807 Enrollment ID: I20041111000091 |
| Provider Name | Kieran Nicholson |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1205843653 PECOS PAC ID: 9335105584 Enrollment ID: I20041208001160 |
| Provider Name | Venketa Moparthi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699797548 PECOS PAC ID: 7315903440 Enrollment ID: I20041209000545 |
| Provider Name | Karen Omara |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1235112269 PECOS PAC ID: 7416907670 Enrollment ID: I20050125000920 |
| Provider Name | Ketan N Jobanputra |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1992818827 PECOS PAC ID: 1951366228 Enrollment ID: I20050203000719 |
| Provider Name | Semone Michelle West |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750475109 PECOS PAC ID: 1759332596 Enrollment ID: I20050209000293 |
| Provider Name | Rajive Tandon |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1104878115 PECOS PAC ID: 7113814419 Enrollment ID: I20050418000870 |
| Provider Name | Ernesto T Tan |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1699882084 PECOS PAC ID: 1951349240 Enrollment ID: I20050418001131 |
| Provider Name | Alvia Sabahat |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699707851 PECOS PAC ID: 2365480860 Enrollment ID: I20050425000175 |
| Provider Name | Robert Sharpe |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588631329 PECOS PAC ID: 9234168139 Enrollment ID: I20050811000083 |
| Provider Name | John K Song |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1922099084 PECOS PAC ID: 5395779631 Enrollment ID: I20050926000530 |
| Provider Name | Manuel Alberto Franco |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083671341 PECOS PAC ID: 0840216578 Enrollment ID: I20051024000304 |
| Provider Name | Humaira F Saiyed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487745006 PECOS PAC ID: 0840272068 Enrollment ID: I20051117000376 |
| Provider Name | Rashmi C Tomur |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1770686305 PECOS PAC ID: 4486676822 Enrollment ID: I20051230000515 |
| Provider Name | Donna J Sweetland |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1740374909 PECOS PAC ID: 2860412392 Enrollment ID: I20060109000810 |
| Provider Name | Funmilayo A Macaulay |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1356441844 PECOS PAC ID: 3274557459 Enrollment ID: I20060116000426 |
| Provider Name | Kizito Ojiako |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1679520431 PECOS PAC ID: 6800800152 Enrollment ID: I20060126000175 |
| Provider Name | Arlette F Brown |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1275580565 PECOS PAC ID: 8426060898 Enrollment ID: I20060629000269 |
| Provider Name | Ghassan Rahhal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942225909 PECOS PAC ID: 7315831427 Enrollment ID: I20060925000528 |
| Provider Name | Sunit Singla |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1760594253 PECOS PAC ID: 8921005398 Enrollment ID: I20061026000593 |
| Provider Name | Rushdi H Alul |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1649365529 PECOS PAC ID: 6608876917 Enrollment ID: I20070111000140 |
| Provider Name | Gianluca Lazzaro |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1235288416 PECOS PAC ID: 7517069065 Enrollment ID: I20070301000314 |
| Provider Name | Yetunde Johnson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164622361 PECOS PAC ID: 3779675996 Enrollment ID: I20070817000343 |
| Provider Name | Jyothi Jolepalem |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1669574299 PECOS PAC ID: 6103910880 Enrollment ID: I20070926000346 |
| Provider Name | Gaurav Kapoor |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1245225192 PECOS PAC ID: 6800869322 Enrollment ID: I20071005000561 |
| Provider Name | Laron Phillips |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285834440 PECOS PAC ID: 8921195272 Enrollment ID: I20071102000200 |
| Provider Name | Nazneen Ahmed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215926621 PECOS PAC ID: 9638250335 Enrollment ID: I20080119000128 |
| Provider Name | Hari Gadde |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1285601872 PECOS PAC ID: 0143309179 Enrollment ID: I20080502000130 |
| Provider Name | Angela Intili |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1114080033 PECOS PAC ID: 3476625872 Enrollment ID: I20080630000370 |
| Provider Name | Edward K Frye |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1952392557 PECOS PAC ID: 2668370537 Enrollment ID: I20080702000312 |
| Provider Name | Binita D Parikh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881870699 PECOS PAC ID: 5991871451 Enrollment ID: I20080906000035 |
| Provider Name | Pavana Radhakrishna |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053595934 PECOS PAC ID: 3779650833 Enrollment ID: I20080916000353 |
| Provider Name | Shital T Mehta |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205054608 PECOS PAC ID: 9335207463 Enrollment ID: I20081018000214 |
| Provider Name | Omer Yusaf |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1669585956 PECOS PAC ID: 7618931627 Enrollment ID: I20081101000103 |
| Provider Name | Amir Hossein Vafa |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1881818326 PECOS PAC ID: 2365501350 Enrollment ID: I20081105000617 |
| Provider Name | Narayana Swamy Nagubadi |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1295782365 PECOS PAC ID: 6709945264 Enrollment ID: I20081112000781 |
| Provider Name | Asmamaw K Beyene |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326161241 PECOS PAC ID: 3274694849 Enrollment ID: I20081202000389 |
| Provider Name | Rita M Zafra |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1003080847 PECOS PAC ID: 7911068713 Enrollment ID: I20081212000043 |
| Provider Name | Syeda A Fatima |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215191408 PECOS PAC ID: 3779646294 Enrollment ID: I20090109000427 |
| Provider Name | Jonathan E Vogel |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1104007533 PECOS PAC ID: 0840353892 Enrollment ID: I20090116000352 |
| Provider Name | Shannon M Jennings |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285715847 PECOS PAC ID: 8224003017 Enrollment ID: I20090202000380 |
| Provider Name | Vipuli E Jayesinghe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265673701 PECOS PAC ID: 1355499773 Enrollment ID: I20090423000169 |
| Provider Name | Mark Borsody |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1215179767 PECOS PAC ID: 5890844575 Enrollment ID: I20090529000231 |
| Provider Name | Syed A Rahim |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124118625 PECOS PAC ID: 6507946654 Enrollment ID: I20090623000341 |
| Provider Name | Janine A Tanner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417183823 PECOS PAC ID: 4880745678 Enrollment ID: I20090708000376 |
| Provider Name | Brian Winkleman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1982818357 PECOS PAC ID: 8325112782 Enrollment ID: I20090803000152 |
| Provider Name | Brian Egan |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1366439226 PECOS PAC ID: 7416000401 Enrollment ID: I20090810000288 |
| Provider Name | Vinitha Kunchala |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477756732 PECOS PAC ID: 8224174776 Enrollment ID: I20091014000176 |
| Provider Name | Michael Joseph Bommarito |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1235150939 PECOS PAC ID: 5799785283 Enrollment ID: I20091021000351 |
| Provider Name | Poonam P Thaker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508030057 PECOS PAC ID: 2769520287 Enrollment ID: I20091103000547 |
| Provider Name | Colleen Marie Grandowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265768352 PECOS PAC ID: 5294876439 Enrollment ID: I20100109000163 |
| Provider Name | Ramalingappa Mukunda |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972572675 PECOS PAC ID: 5799812012 Enrollment ID: I20100419000506 |
| Provider Name | Sarat C Munukutla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225081110 PECOS PAC ID: 3072577303 Enrollment ID: I20100429001158 |
| Provider Name | Johnny Williamson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144310509 PECOS PAC ID: 9335277631 Enrollment ID: I20100506000811 |
| Provider Name | Francis L Hobson |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1679538193 PECOS PAC ID: 2769455641 Enrollment ID: I20100527000145 |
| Provider Name | Daniel C Omalley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811932056 PECOS PAC ID: 5395869663 Enrollment ID: I20100824000855 |
| Provider Name | Mousab Almusaddy |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1699720896 PECOS PAC ID: 9335123173 Enrollment ID: I20100826001127 |
| Provider Name | Wuraola I Omotosho |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427222884 PECOS PAC ID: 3173647609 Enrollment ID: I20100903000740 |
| Provider Name | Surendra Mohan Gulati |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1558543348 PECOS PAC ID: 7911190624 Enrollment ID: I20101026000740 |
| Provider Name | Peter Mihalakakos |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1720022031 PECOS PAC ID: 5890793350 Enrollment ID: I20101104001217 |
| Provider Name | Anandita G Gephart |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790709343 PECOS PAC ID: 2961698923 Enrollment ID: I20101202000444 |
| Provider Name | Saif U Shah |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1396914065 PECOS PAC ID: 0345422333 Enrollment ID: I20110311000803 |
| Provider Name | Anuli C Ezimako |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1598949893 PECOS PAC ID: 2961685904 Enrollment ID: I20110329000168 |
| Provider Name | Diana C Doeing |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1730341983 PECOS PAC ID: 2961689955 Enrollment ID: I20110531000125 |
| Provider Name | Vipul Singla |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1164448387 PECOS PAC ID: 8022296177 Enrollment ID: I20110621000184 |
| Provider Name | Sarah Mann |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720171911 PECOS PAC ID: 1850579152 Enrollment ID: I20110708000198 |
| Provider Name | Anoosh Salman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871793869 PECOS PAC ID: 9133398316 Enrollment ID: I20110803000888 |
| Provider Name | Ifeanyi Iwuchukwu |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1215169974 PECOS PAC ID: 6608056312 Enrollment ID: I20110808000828 |
| Provider Name | Natalie Lambajian-drummond |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1457361636 PECOS PAC ID: 6305016833 Enrollment ID: I20110819000126 |
| Provider Name | Mahreen Majid |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912158882 PECOS PAC ID: 7416127014 Enrollment ID: I20110908001771 |
| Provider Name | Nicole J Spencer |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1518123520 PECOS PAC ID: 4688845845 Enrollment ID: I20110926000229 |
| Provider Name | Mahwesh Javed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710149224 PECOS PAC ID: 4587837075 Enrollment ID: I20111028000035 |
| Provider Name | Beth Helme-smith |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1023179389 PECOS PAC ID: 0749453207 Enrollment ID: I20111102000034 |
| Provider Name | Nausheen Samee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487818415 PECOS PAC ID: 7214100387 Enrollment ID: I20111105000009 |
| Provider Name | Javed Sheikh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790888931 PECOS PAC ID: 1153321476 Enrollment ID: I20120130000867 |
| Provider Name | Marquess T Wilson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1093963670 PECOS PAC ID: 7810157179 Enrollment ID: I20120322000697 |
| Provider Name | Jonette P Belicena |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1134117344 PECOS PAC ID: 1557523321 Enrollment ID: I20120425000034 |
| Provider Name | Rowena G Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780977975 PECOS PAC ID: 9436315405 Enrollment ID: I20120718000712 |
| Provider Name | Omar Ahmed |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1639312556 PECOS PAC ID: 2365698669 Enrollment ID: I20120801000630 |
| Provider Name | Sai Sunkara |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1801024153 PECOS PAC ID: 1557519089 Enrollment ID: I20120907000129 |
| 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 | Syeda K Ali |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265732176 PECOS PAC ID: 5092965525 Enrollment ID: I20121018000567 |
| Provider Name | Jennifer L Besse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043536204 PECOS PAC ID: 8729238837 Enrollment ID: I20121026000308 |
| Provider Name | Sarah E Perkins |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1013173061 PECOS PAC ID: 3870743610 Enrollment ID: I20121101000243 |
| Provider Name | Sylvia Trevino |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1659564573 PECOS PAC ID: 9234380148 Enrollment ID: I20121126000592 |
| Provider Name | Kafila A Suleiman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407167398 PECOS PAC ID: 0143472332 Enrollment ID: I20121217000088 |
| Provider Name | Amber Kazi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780847020 PECOS PAC ID: 5294988556 Enrollment ID: I20130117000088 |
| Provider Name | Menka Desai |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1912155169 PECOS PAC ID: 9537313283 Enrollment ID: I20130204000407 |
| Provider Name | Zenabu Sidiki |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932377660 PECOS PAC ID: 9537314265 Enrollment ID: I20130304000527 |
| Provider Name | Rahul K Agarwal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992930374 PECOS PAC ID: 5294980512 Enrollment ID: I20130312000333 |
| Provider Name | Sheikh Latif |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306052345 PECOS PAC ID: 4082771456 Enrollment ID: I20130410000128 |
| Provider Name | Charone T Tolbert |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1033386461 PECOS PAC ID: 6305988361 Enrollment ID: I20130417000299 |
| Provider Name | David Vallejo |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1699085381 PECOS PAC ID: 2466699541 Enrollment ID: I20130508000640 |
| 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 | Eyad Karzoun |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1649470196 PECOS PAC ID: 2466693403 Enrollment ID: I20130802000270 |
| Provider Name | Gaurang D Gujarathi |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1124314349 PECOS PAC ID: 6507008547 Enrollment ID: I20130805000280 |
| Provider Name | Muneeb Qadri |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972815033 PECOS PAC ID: 2860634698 Enrollment ID: I20130807000749 |
| Provider Name | Eva L Pilcher |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1033371133 PECOS PAC ID: 2365684446 Enrollment ID: I20130820000857 |
| Provider Name | Nijal V Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649412370 PECOS PAC ID: 5395901680 Enrollment ID: I20130823000436 |
| Provider Name | Ashley M Chappell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194070458 PECOS PAC ID: 1355575606 Enrollment ID: I20130930000170 |
| Provider Name | James L Lubawski |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1679729511 PECOS PAC ID: 2860627833 Enrollment ID: I20131029000127 |
| Provider Name | Maria Onagan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1689871212 PECOS PAC ID: 6507091402 Enrollment ID: I20131031000795 |
| Provider Name | Faris Abdul-kadem Al-gebory |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1851421705 PECOS PAC ID: 7416054549 Enrollment ID: I20131212001291 |
| Provider Name | Rubeena Anjum |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114187531 PECOS PAC ID: 0941492581 Enrollment ID: I20140115000103 |
| Provider Name | Ashima Sahni |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1972819720 PECOS PAC ID: 2961630801 Enrollment ID: I20140122001349 |
| Provider Name | Judith Mattox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841629821 PECOS PAC ID: 7911136437 Enrollment ID: I20140204000195 |
| Provider Name | Sajoy P Varghese |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902053077 PECOS PAC ID: 6608018411 Enrollment ID: I20140429002230 |
| Provider Name | Sadaf Ashfaq Farooqi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366739013 PECOS PAC ID: 7113175845 Enrollment ID: I20140711000438 |
| Provider Name | Basel Katerji |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1508152315 PECOS PAC ID: 9032357926 Enrollment ID: I20140722001680 |
| Provider Name | Shamna Haris |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1073899522 PECOS PAC ID: 5991921165 Enrollment ID: I20140723002527 |
| Provider Name | Melita Igbokwe |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1790004620 PECOS PAC ID: 9537385232 Enrollment ID: I20140731002016 |
| Provider Name | Leanne M Bishop |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1578811147 PECOS PAC ID: 7810114428 Enrollment ID: I20140805001982 |
| Provider Name | Olatokunbo Shobande |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1972711513 PECOS PAC ID: 6901077973 Enrollment ID: I20141007002783 |
| Provider Name | Vikramjit S Gill |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639227374 PECOS PAC ID: 0345343729 Enrollment ID: I20141106000101 |
| Provider Name | Fares Hamad |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1275831521 PECOS PAC ID: 6204158850 Enrollment ID: I20141210000130 |
| Provider Name | Armughan Bangash |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1962679852 PECOS PAC ID: 3375682578 Enrollment ID: I20150313002318 |
| Provider Name | Amanda R Benjamin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467859454 PECOS PAC ID: 6204154354 Enrollment ID: I20150421001800 |
| Provider Name | Rebecca Leonhardt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164833737 PECOS PAC ID: 1951622711 Enrollment ID: I20150604001652 |
| Provider Name | Tony V Pallan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942512827 PECOS PAC ID: 8325286693 Enrollment ID: I20150805008684 |
| Provider Name | Stanley Okon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023243334 PECOS PAC ID: 0547577231 Enrollment ID: I20150911002454 |
| 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 | Shabirhusain S Abadin |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1467712596 PECOS PAC ID: 5496910531 Enrollment ID: I20151001002471 |
| Provider Name | Sreekanth Uppuluri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881951630 PECOS PAC ID: 0749412781 Enrollment ID: I20151020000203 |
| Provider Name | Anjana Nair |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1609079219 PECOS PAC ID: 9739336587 Enrollment ID: I20160112002551 |
| Provider Name | Kelly A Morris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356716989 PECOS PAC ID: 4082917208 Enrollment ID: I20160122000002 |
| Provider Name | Ryoko Noguchi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669720694 PECOS PAC ID: 5294057063 Enrollment ID: I20160803000998 |
| Provider Name | Samer R Rajjoub |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1891920120 PECOS PAC ID: 2567694664 Enrollment ID: I20160818002317 |
| Provider Name | Ashley Beane |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467808089 PECOS PAC ID: 7315233251 Enrollment ID: I20160901001261 |
| Provider Name | Haris Hamsakutty |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912220864 PECOS PAC ID: 5294022182 Enrollment ID: I20160920002703 |
| Provider Name | Cassandra Waramit |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235675091 PECOS PAC ID: 6709160807 Enrollment ID: I20170309002342 |
| Provider Name | Anas F Lababidi |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1932553583 PECOS PAC ID: 8628354990 Enrollment ID: I20170421000857 |
| Provider Name | Sarah M Khan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1922446186 PECOS PAC ID: 1052617362 Enrollment ID: I20170425002378 |
| Provider Name | Hasan Al Janabi |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1255530119 PECOS PAC ID: 8426228008 Enrollment ID: I20170705001400 |
| Provider Name | Lauren M Ghee |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1821345349 PECOS PAC ID: 9830462191 Enrollment ID: I20170907002736 |
| Provider Name | Kiran Ijaz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407183270 PECOS PAC ID: 6800044660 Enrollment ID: I20170928003857 |
| Provider Name | Stephanie N Miller |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1700307709 PECOS PAC ID: 5395001416 Enrollment ID: I20171106002766 |
| Provider Name | Tatyana Kholod Sanders |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811326523 PECOS PAC ID: 8729200357 Enrollment ID: I20171218001966 |
| Provider Name | Jasshan M Mehrotra |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1194135368 PECOS PAC ID: 6305147398 Enrollment ID: I20180220000351 |
| Provider Name | Stephanie V Hernandez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215297221 PECOS PAC ID: 0042526683 Enrollment ID: I20180502000452 |
| Provider Name | Ali S Anwar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710328703 PECOS PAC ID: 9830328020 Enrollment ID: I20180808002961 |
| Provider Name | Zia Samad |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1639551195 PECOS PAC ID: 1557610243 Enrollment ID: I20180814000042 |
| Provider Name | Brandon Michael Pardi |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1104192947 PECOS PAC ID: 9335459890 Enrollment ID: I20180829000040 |
| Provider Name | Irfan Choudhry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124369855 PECOS PAC ID: 3577860295 Enrollment ID: I20181107001154 |
| Provider Name | Mustafa Tai |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689023152 PECOS PAC ID: 8123310927 Enrollment ID: I20181112000766 |
| Provider Name | Hadi Farouk Shaaban |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1659529196 PECOS PAC ID: 4385879378 Enrollment ID: I20190221000196 |
| Provider Name | Kristin M Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104399237 PECOS PAC ID: 5890035091 Enrollment ID: I20190326002627 |
| Provider Name | Alok M Patel |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1457627465 PECOS PAC ID: 5092061788 Enrollment ID: I20190405001793 |
| Provider Name | Nischal Raya |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1326429747 PECOS PAC ID: 1254622707 Enrollment ID: I20190529003287 |
| Provider Name | Nirmal Dass |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134603046 PECOS PAC ID: 6002149911 Enrollment ID: I20190607002460 |
| Provider Name | Angie Tripathi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407302052 PECOS PAC ID: 7416280268 Enrollment ID: I20190610001863 |
| Provider Name | Christina Gavoni |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548829450 PECOS PAC ID: 3476882929 Enrollment ID: I20190909001082 |
| Provider Name | Tariq S Lateef |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1619364221 PECOS PAC ID: 0840522678 Enrollment ID: I20191029001323 |
| Provider Name | Baha'a Abdel-fattah Al-azzam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477087369 PECOS PAC ID: 8022440429 Enrollment ID: I20191122000482 |
| Provider Name | Michael Meng Chen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1558757757 PECOS PAC ID: 9335424449 Enrollment ID: I20191210002786 |
| Provider Name | Alaina Lastres |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184758286 PECOS PAC ID: 9739513201 Enrollment ID: I20191217001441 |
| Provider Name | Ruchir Shah |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1396033437 PECOS PAC ID: 1557656501 Enrollment ID: I20191223000858 |
| Provider Name | Rajiv Narula |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1982959979 PECOS PAC ID: 6709147689 Enrollment ID: I20191223001027 |
| Provider Name | Neeraj Singh |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1194160457 PECOS PAC ID: 6709136443 Enrollment ID: I20191227000016 |
| Provider Name | Joseph Vitello |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1962508747 PECOS PAC ID: 1951723899 Enrollment ID: I20200622002191 |
| Provider Name | Zaid Abdelsattar |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1760793293 PECOS PAC ID: 3375790033 Enrollment ID: I20200728000026 |
| Provider Name | Samantha Collins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306456819 PECOS PAC ID: 4880010834 Enrollment ID: I20200820002485 |
| Provider Name | Wissam Raad |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1104063213 PECOS PAC ID: 8921317785 Enrollment ID: I20200930000318 |
| Provider Name | Veronica Gore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902403298 PECOS PAC ID: 0547680829 Enrollment ID: I20201027000815 |
| Provider Name | Ayisha Jameel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508194887 PECOS PAC ID: 6002058062 Enrollment ID: I20201104001704 |
| Provider Name | Karissa Merkel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538779533 PECOS PAC ID: 0547674202 Enrollment ID: I20210121000741 |
| Provider Name | Zara Mehta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235768086 PECOS PAC ID: 4880008465 Enrollment ID: I20210121001753 |
| Provider Name | Sagarkumar N Patel |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1962922187 PECOS PAC ID: 3375958051 Enrollment ID: I20210210000441 |
| Provider Name | Behzad Elahi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1932549698 PECOS PAC ID: 5991073678 Enrollment ID: I20210616002559 |
| Provider Name | Daniel Marks |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1457794406 PECOS PAC ID: 5698901585 Enrollment ID: I20210624002060 |
| Provider Name | John Fox Mast |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811488646 PECOS PAC ID: 6800223710 Enrollment ID: I20210706001423 |
| Provider Name | Ximena Morales |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1477537256 PECOS PAC ID: 9739159039 Enrollment ID: I20210708001653 |
| Provider Name | Ambreen Danish Aslam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700382447 PECOS PAC ID: 4880942747 Enrollment ID: I20210713000145 |
| Provider Name | Nausheen Syed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871028423 PECOS PAC ID: 3577838267 Enrollment ID: I20210714000098 |
| Provider Name | Arjun Dev Mehta |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1801238449 PECOS PAC ID: 3779887443 Enrollment ID: I20210806001930 |
| Provider Name | Swati Laroia Coon |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1306284765 PECOS PAC ID: 8224255492 Enrollment ID: I20210813001487 |
| Provider Name | Tischelle Gatlin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1679007116 PECOS PAC ID: 7911302724 Enrollment ID: I20210817002207 |
| Provider Name | Ramakrishna Veluri |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033525050 PECOS PAC ID: 4587978606 Enrollment ID: I20210819003017 |
| Provider Name | Baqir Anwer Jakvani |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1407388473 PECOS PAC ID: 0648675264 Enrollment ID: I20210819003495 |
| Provider Name | Kyle Yuichi Ogami |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1801276571 PECOS PAC ID: 9638471626 Enrollment ID: I20210830000463 |
| Provider Name | James Voci |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1366476715 PECOS PAC ID: 6002863081 Enrollment ID: I20210830001788 |
| 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 | Chike Ilorah |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1619382355 PECOS PAC ID: 8729392402 Enrollment ID: I20210909001179 |
| Provider Name | Linesse Md Vega |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114105897 PECOS PAC ID: 6002047206 Enrollment ID: I20210921000130 |
| Provider Name | Mohammad Adnan Ul Haq |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659805281 PECOS PAC ID: 7012268022 Enrollment ID: I20211011001880 |
| Provider Name | Hassan Ahmad |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1851772057 PECOS PAC ID: 0244500783 Enrollment ID: I20220406001659 |
| Provider Name | Umakanth Avula |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1124479167 PECOS PAC ID: 9133521859 Enrollment ID: I20220413000734 |
| Provider Name | Parinda Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154051365 PECOS PAC ID: 0941681134 Enrollment ID: I20220719002993 |
| Provider Name | Jason Joseph Miiller |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699069138 PECOS PAC ID: 7810117702 Enrollment ID: I20220728002702 |
| Provider Name | Francisco Benavides |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1073968293 PECOS PAC ID: 1254623176 Enrollment ID: I20220804001015 |
| Provider Name | Mohammed Shahrukh Fahad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841752839 PECOS PAC ID: 8527441989 Enrollment ID: I20220817001965 |
| Provider Name | Juan Francisco Rodriguez |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1679924617 PECOS PAC ID: 6002210119 Enrollment ID: I20220825003413 |
| Provider Name | Samah Mohiuddin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1336455112 PECOS PAC ID: 0143462614 Enrollment ID: I20220831003353 |
| Provider Name | Ali A Saherwala |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1689036352 PECOS PAC ID: 7719315522 Enrollment ID: I20220912000246 |
| Provider Name | Jaelyn Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659909372 PECOS PAC ID: 6800209115 Enrollment ID: I20220920003694 |
| Provider Name | Melanie Winningham |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1588954788 PECOS PAC ID: 9335434752 Enrollment ID: I20220924000337 |
| Provider Name | Tanya Scurry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225243009 PECOS PAC ID: 9133400237 Enrollment ID: I20220929002787 |
| Provider Name | Mohsin Ali |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1093912909 PECOS PAC ID: 8123113248 Enrollment ID: I20221011001591 |
| 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 | Meaghan T Sterchi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578299681 PECOS PAC ID: 7911378286 Enrollment ID: I20230124002045 |
| Provider Name | Clark Russell Murray |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1699207241 PECOS PAC ID: 5395018378 Enrollment ID: I20230215001159 |
| Provider Name | Seema Kapur |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1639299209 PECOS PAC ID: 3173674694 Enrollment ID: I20230216001614 |
| Provider Name | Tejas Ranade |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1043702459 PECOS PAC ID: 9830563873 Enrollment ID: I20230316001963 |
| Provider Name | Dinuk Abeysekera |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366616534 PECOS PAC ID: 5890970164 Enrollment ID: I20230316002693 |
| Provider Name | Bo Leung |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1932635539 PECOS PAC ID: 4688087513 Enrollment ID: I20230320003026 |
| Provider Name | Princy George |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467800466 PECOS PAC ID: 7517293293 Enrollment ID: I20230420001390 |
| Provider Name | Monica Singh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760045256 PECOS PAC ID: 5799156444 Enrollment ID: I20230801001640 |
| Provider Name | Steven Meek |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093005639 PECOS PAC ID: 6709013766 Enrollment ID: I20230929002664 |
| Provider Name | Joel Radhames Nunez Gonzalez |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1497066997 PECOS PAC ID: 3577862622 Enrollment ID: I20231027003038 |
| Provider Name | Pranusha Pinna |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1861983660 PECOS PAC ID: 6406105154 Enrollment ID: I20231031001624 |
| Provider Name | Kasey Lynn Gildersleeve |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1790012870 PECOS PAC ID: 6305158460 Enrollment ID: I20231108000273 |
| Provider Name | Rami Assadi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1265819478 PECOS PAC ID: 8325343247 Enrollment ID: I20231108002019 |
| Provider Name | Katherine Nel Flaherty |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1619759685 PECOS PAC ID: 6901254622 Enrollment ID: I20231118000104 |
| Provider Name | Jeremiah Bell |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1639533870 PECOS PAC ID: 0244524338 Enrollment ID: I20231201001258 |
| Provider Name | Sam Saha |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1629394390 PECOS PAC ID: 3870733181 Enrollment ID: I20231206001098 |
| Provider Name | Collin Sharp |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1659575348 PECOS PAC ID: 8123173176 Enrollment ID: I20240129002823 |
| Provider Name | Steven Tversky |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1356683874 PECOS PAC ID: 1658633664 Enrollment ID: I20240224000588 |
| Provider Name | Eyad Alhaj |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1770698375 PECOS PAC ID: 4981649217 Enrollment ID: I20240426002976 |
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 |