AISHA TATE-ODOM (NPI# 1023675741) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023675741 |
| Entity Type | Individual |
| Full Name | AISHA TATE-ODOM |
| Credential | APN |
| Practice Address |
14506 Spaulding Ave Midlothian IL 60445-3020 |
| Practice Telephone | 7082659377 |
| Mailing Telephone | 7082659377 |
| Enumeration Date | 2019-05-29 |
| Last Update Date | 2019-05-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
209.01974 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209.019074 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
14506 SPAULDING AVE |
| City | MIDLOTHIAN |
| State | IL |
| Zip Code | 60445-3020 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861911398 | Paula Marie Jensen Hallahan | Psychologist | Hermansen Elementary School, 101 Wesglen Parkway, Romeoville, IL 60445 | 2017-09-15 |
| 1861933756 | Reginald Castillo | Emergency Medical Technician, Paramedic | 4939 East Circle Dr. #206, Crestwood, IL 60445 | 2017-03-13 |
| 1801259684 | Bruce Frank Leo | Hearing Instrument Specialist | 5553 W. 127th St, Crestwood, IL 60445 | 2016-03-30 |
| 1801291687 | Annie Eyer | Behavioral Analyst | 4942 138th Place, Crestwood, IL 60445 | 2014-10-23 |
| 1679997266 | Phoenix Behavioral Services, Inc | Case Management | 4649 147th Street, Midlothian, IL 60445 | 2014-02-18 |
| 1841537149 | Lacy Carol Little | Speech-Language Pathologist | 14715 Leclaire Ave., Midlothian, IL 60445 | 2013-01-08 |
| 1164709291 | Kathleen Chaudhari | Pharmacist | 4800 W 148th Street, Midlothian, IL 60445 | 2011-11-03 |
| 1063715498 | Amanda Rea Bird | Behavioral Analyst | 5415 129th Pl, Apt 4, Crestwood, IL 60445 | 2010-12-07 |
| 1831376615 | Plaza Nursing & Rehab Center, LLC | Durable Medical Equipment & Medical Supplies | 3249 W 147th St, Midlothiian, IL 60445 | 2008-01-24 |
| 1154475630 | Kevin Martin Bargamian | Dentist | 13549 South Cicero Avenue, Crestwood, IL 60445 | 2007-01-22 |
| Find all providers in zip 60445 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730799917 | Darnesha Shaunte Clanton | Nurse Practitioner | 401 Rockaway Dr, Midlothian, TX 76065-1199 | 2020-08-03 |
| 1740816685 | Anjalyse Maria Valenti | Nurse Practitioner | 542 Glenpark Ln, Midlothian, VA 23114-3067 | 2020-03-22 |
| 1861027419 | Mussie Futwi Mebrahtu | Nurse Practitioner | 214 Canterbury Ct, Midlothian, TX 76065-1417 | 2020-03-04 |
| 1457996167 | Elizabeth Murray | Nurse Practitioner | 1230 Alverser Dr Ste 104, Midlothian, VA 23113-2653 | 2019-11-18 |
| 1487214508 | Genevieve R. Matulin | Nurse Practitioner | 14319 Jeffries Pl, Midlothian, VA 23114-4359 | 2019-06-20 |
| 1780243329 | Brandi Hartsfield | Nurse Practitioner | 531 Totten Dr, Midlothian, VA 23113-3440 | 2019-06-07 |
| 1659861961 | Shaquita I. Alexander | Nurse Practitioner | 6204 Crowne Creek Dr, Midlothian, VA 23112-8315 | 2018-05-11 |
| 1245751874 | Kristyn Janine Childress | Nurse Practitioner | 14500 Needham Market Rd, Midlothian, VA 23112-1683 | 2017-07-05 |
| 1124567581 | Crystal Mann | Nurse Practitioner | 12000 Old Bailey Bridge Rd, Midlothian, VA 23112-3120 | 2017-02-18 |
| 1093197469 | Kristle Chambers | Nurse Practitioner | 14507 Lavenham Ln, Midlothian, VA 23112 | 2015-06-22 |
| Find all providers in MIDLOTHIAN | ||||
| City | MIDLOTHIAN |
| Zip Code | 60445 |
Please comment or provide details below to improve the information on AISHA TATE-ODOM.
| 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.