MR. LARRY JAMES MATURIN JR. (NPI# 1013365360) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013365360 |
| Entity Type | Individual |
| Full Name | MR. LARRY JAMES MATURIN JR. |
| Credential | RN, APN, ACNS-BC |
| Practice Address |
990 W Fullerton Ave Chicago IL 60614-2458 |
| Mailing Address |
3704 Harms Rd Joliet IL 60435-9046 |
| Practice Telephone | 8156036212 |
| Mailing Telephone | 8156036212 |
| Enumeration Date | 2016-05-27 |
| Last Update Date | 2016-05-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WE0003X |
Registered Nurse Specialization: Emergency |
041.323524 | IL | Nursing Service Providers |
| Y | 364S00000X | Clinical Nurse Specialist | 209.010006 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 364SA2200X |
Clinical Nurse Specialist Specialization: Adult Health |
209.010006 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
990 W FULLERTON AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60614-2458 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659487544 | Edmund Val Padleckas | Dentist | 990 W Fullerton Ave, Suite 460, Chicago, IL 60614-2458 | 2006-08-22 |
| 1215142344 | Michael Royal Mintz | Dentist | 990 W Fullerton Ave, Suite 450, Chicago, IL 60614-2458 | 2007-05-11 |
| 1689889727 | Michael R Mintz D.d.s.,p.c. | Dentist | 990 W Fullerton Ave, Suite 450, Chicago, IL 60614-2458 | 2007-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487266516 | Taylor Connington | Pharmacist | 843 W Armitage Ave, Chicago, IL 60614 | 2020-08-19 |
| 1356975692 | Amarilis Diaz | Social Worker | Terry Hefter Associates, LLC, 1731 N. Marcey Suite 535, Chicago, IL 60614 | 2020-02-25 |
| 1457902975 | Michele Waggoner | Physical Therapist | 2515 N. Clark St, Chicago, IL 60614 | 2019-09-25 |
| 1669031936 | Justin Pomeroy | Acupuncturist | 1350 W. Schubert Ave., Chicago, IL 60614 | 2019-06-11 |
| 1801451547 | Amanda Harris | Counselor | 2451 N Lincoln Ave # 206, Chicago, IL 60614 | 2019-05-08 |
| 1780164574 | Danielle Trokey | Psychiatry & Neurology | 2515 N Clark St Ste 801, Chicago, IL 60614 | 2018-08-21 |
| 1841707353 | Madison Counseling Solutions LLC | Social Worker | 2502 N. Clark St., Chicago, IL 60614 | 2018-01-05 |
| 1386154011 | Allison Cooper Boyan | Occupational Therapist | 1640 N. Wells St., Unit 103, Chicago, IL 60614 | 2017-10-09 |
| 1245759653 | Eileen Davidson Siegel | Physician Assistant | 2073 N. Clybourn Ave., Chicago, IL 60614 | 2017-09-18 |
| 1447779814 | Elizabeth Hobart | Psychologist | 1800 W. Diversey Pkwy, Unit H, Chicago, IL 60614 | 2017-09-16 |
| Find all providers in zip 60614 | ||||
| Taxonomy Code | 364S00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| A registered nurse who, through a graduate degree program in nursing, or through a formal post-basic education program or continuing education courses and clinical experience, is expert in a specialty area of nursing practice within one or more of the components of direct patient/client care, consultation, education, research and administration. |
| Notes: Sources: American Nurses Association, American Nurses Credentialing Center, 1996 Certification Catalogue and The Interagency Conference on Nursing Statistics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639547417 | Virginia Ann Baker | Clinical Nurse Specialist | 5758 S Maryland Ave # Mc9024, Chicago, IL 60637-1426 | 2015-09-09 |
| 1245615947 | Gabriel Oluwakotanmi | Clinical Nurse Specialist | 8056 S Harper Ave, Chicago, IL 60619-4637 | 2015-07-23 |
| 1831435189 | Rena Thompson | Clinical Nurse Specialist | 7537 N Bell Ave, Suite 1, Chicago, IL 60645-2484 | 2012-12-13 |
| 1225527641 | Kerstin Litwin | Clinical Nurse Specialist | 5145 N California Ave, Chicago, IL 60625-3687 | 2018-05-02 |
| 1952778318 | Ana Bedon | Clinical Nurse Specialist | 836 W Wellington Ave, Chicago, IL 60657-5147 | 2015-09-01 |
| 1154616928 | Mary Susan Sandrik | Clinical Nurse Specialist | 1500 South California Avenue, Chicago, IL 60608 | 2011-06-09 |
| 1760719074 | Mary H Zeigler | Clinical Nurse Specialist | 345 E Superior St, Chicago, IL 60611-2654 | 2009-11-06 |
| 1932376043 | Jennifer L Clark | Clinical Nurse Specialist | 5841 S Maryland Ave, Chicago, IL 60637-1447 | 2008-05-08 |
| 1235302167 | Debra Ann Walczak | Clinical Nurse Specialist | 1740 W Taylor St, Chicago, IL 60612-7232 | 2008-04-11 |
| 1497942387 | Sue Urbanski | Clinical Nurse Specialist | 5841 S Maryland Ave, Chicago, IL 60637-1447 | 2007-09-25 |
| Find all providers in CHICAGO | ||||
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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.