MR. RENE GARCIA CANTU JR. (NPI# 1013315068) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013315068 |
| Entity Type | Individual |
| Full Name | MR. RENE GARCIA CANTU JR. |
| Credential | IDC |
| Practice Address |
Captain James A. Lovell Federal Health Care Center 3001 Green Bay Road North Chicago IL 60064 |
| Mailing Address |
10816 E Riviera Dr Spring Grove IL 60081-7813 |
| Practice Telephone | 2246107501 |
| Enumeration Date | 2014-12-08 |
| Last Update Date | 2018-11-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
Other Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2216 Monument Ln, Twentynine Palms, CA 92277 | 7608305141 |
| Street Address |
CAPTAIN JAMES A. LOVELL FEDERAL HEALTH CARE CENTER 3001 GREEN BAY ROAD |
| City | NORTH CHICAGO |
| State | IL |
| Zip Code | 60064 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225696982 | Azib Shahid | Internal Medicine | Captain James A. Lovell Federal Health Care Center, 3001 Green Bay Road, North Chicago, IL 60064-3048 | 2019-05-29 |
| 1073032967 | Jordan Anne Bretsch | Dentist | Captain James A. Lovell Federal Health Care Center, 3001 Green Bay Road, North Chicago, IL 60064 | 2017-09-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356964084 | Corbin Paul Edmondson | Student in an Organized Health Care Education/Training Program | 3333 Greenbay Rd, North Chicago, IL 60064 | 2020-05-28 |
| 1881247534 | Aravind Reddy Kuchkuntla | Internal Medicine | 333 Greenbay Road, North Chicago, IL 60064 | 2019-07-22 |
| 1447721121 | Elise Teichman | Nurse Practitioner | 3001 Green Bat Rd, North Chicago, IL 60064 | 2018-12-06 |
| 1841711397 | Abhinav Kumar Nadipalli | Internal Medicine | 3333 Greenbay Road, North Chicago, IL 60064 | 2017-07-05 |
| 1376082503 | A Plus Untited Taxi Limosine | Taxi | 1721 Sheridan Rd, Suite C, North Chicago, IL 60064 | 2017-02-21 |
| 1003351503 | Jacob S Lewis, Dmd, P.C. | Dentist | 2233 Greenbay Rd, North Chicago, IL 60064 | 2016-12-20 |
| 1730635095 | Siva Rama Krishna Cheetirala | Internal Medicine | Rosalind Franklin University of Medicine and Sciences, 3333 Green Bay Road, North Chicago, IL 60064 | 2016-08-28 |
| 1669869764 | Benjamin Pittman | Military Health Care Provider | Uss Tranquility (bhc 1007), Capt James A Lovell Federal Health Care Center, North Chicago, IL 60064 | 2015-04-16 |
| 1134521669 | Seyed Kamran Hejazi Kenari | Internal Medicine | 3001 Green Bay Rd Bldg 133, North Chicago, IL 60064 | 2014-09-16 |
| 1982010575 | Ana Marie Callo-ramirez | Registered Nurse | 3001 North Greenbay Rd, North Chicago, IL 60064 | 2014-07-03 |
| Find all providers in zip 60064 | ||||
| Taxonomy Code | 1710I1002X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Corpsman |
| A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals. |
| Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093158792 | Erik Lee Myers | Military Health Care Provider | Capt James A Lovell Fhcc, North Chicago, IL 60088-8980 | 2013-04-11 |
| 1144607979 | Jessica Anita Reed | Military Health Care Provider | 3001 Green Bay Rd, North Chicago, IL 60064-3048 | 2015-04-30 |
| 1497098875 | Daniel Luis Orsini | Military Health Care Provider | 3001 Greenbay Road, North Chicago, IL 60064 | 2013-04-03 |
| 1386921666 | Lizzette Ann Lorenzo | Military Health Care Provider | 3001 Green Bay Rd, North Chicago, IL 60064-3048 | 2011-11-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215333299 | Jonathan Ramonbeebe | Military Health Care Provider | 3694 Minnesota Ave Apt D, Great Lakes, IL 60088-1714 | 2014-11-18 |
| 1316340615 | Kevin Thomas | Military Health Care Provider | 1126 Furlong Dr, Libertyville, IL 60048-3701 | 2014-09-30 |
| 1306255641 | Brent Thomas Graceffa | Military Health Care Provider | 107 Strawbridge Dr, Rockton, IL 61072-2957 | 2014-08-12 |
| 1194148304 | Steven Flannagan | Military Health Care Provider | 420 Heatherwood Dr, Oswego, IL 60543-7587 | 2014-01-23 |
| 1164736302 | Clinton Lariscy | Military Health Care Provider | 3355 Illinois St, Recruit Training Command Great Lakes, Great Lakes, IL 60088 | 2010-07-29 |
| 1497917876 | Scott David Arnold | Military Health Care Provider | 320 Dewey Ave Ste A, Naval Special Warfare Preparatory School Bldg 322, Great Lakes, IL 60088-2911 | 2008-06-27 |
| 1184883688 | Michael Paul Coffman | Military Health Care Provider | 601 D Street, Great Lakes, IL 60088-2822 | 2008-06-09 |
| 1265691554 | Michael Ivan Arnold | Military Health Care Provider | 328 W Biros Ln, Round Lake, IL 60073-5607 | 2008-06-03 |
| 1184809048 | Rodolfo Pineda Manansala | Military Health Care Provider | 601 D St Bldg 130-h, Great Lakes, IL 60088-2822 | 2008-01-09 |
| 1871797514 | Keith Martin Rawls | Military Health Care Provider | 3540 Westover Rd Apt A, Fort Sheridan, IL 60037-1004 | 2007-06-14 |
| Find all providers with the same taxonomy | ||||
| City | NORTH CHICAGO |
| Zip Code | 60064 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.