DR. EVAN NELSON (NPI# 1053585539) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053585539 |
| Entity Type | Individual |
| Full Name | DR. EVAN NELSON |
| Credential | MD |
| Practice Address |
1775 Dempster St Park Ridge IL 60068-1143 |
| Practice Telephone | 1234567890 |
| Mailing Telephone | 1234567890 |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2012-07-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 036128613 | IL | Allopathic & Osteopathic Physicians |
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
036128613 | IL | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376861708 | Evan Paul Nelson | Dentist | 7 Summit St, Sisseton, SD 57262-2305 | 2010-05-10 |
| 1306825294 | Evan L Nelson Jr. | Otolaryngology | 3517 Fairway Ridge Ln Sw, Rochester, MN 55902-2865 | 2006-01-10 |
| 1154323467 | Evan R Nelson | Physical Medicine & Rehabilitation | 800 West Ave S, La Crosse, WI 54601 | 2005-06-01 |
| 1396092359 | Evan C. Nelson | Physician Assistant | 1518 Mulberry Ave, Muscatine, IA 52761-3433 | 2012-08-09 |
| 1780884056 | Evan Nelson | Physical Therapist | 6908 N Santa Monica Blvd, Fox Point, WI 53217-3942 | 2007-07-24 |
| 1053375212 | Evan L Nelson | Family Medicine | 110 E Mescalero Rd, Roswell, NM 88201-6542 | 2006-04-14 |
| Street Address |
1775 DEMPSTER ST |
| City | PARK RIDGE |
| State | IL |
| Zip Code | 60068-1143 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386642452 | Asya S. Ali | Pathology | 1775 Dempster St, Park Ridge, IL 60068-1143 | 2005-07-12 |
| 1245847656 | Susie Annette Gonzalez | Nurse Practitioner | 1775 Dempster St, Park Ridge, IL 60068-1143 | 2020-09-29 |
| 1598370231 | Maria Staed Dwyer | Physical Therapist | 1775 Dempster St, Park Ridge, IL 60068-1143 | 2020-09-10 |
| 1851906598 | Izabela Koszczuk | Physical Therapist | 1775 Dempster St, Park Ridge, IL 60068-1143 | 2020-09-10 |
| 1760097406 | Mark Andrew Fasick | Physical Therapist | 1775 Dempster St, Park Ridge, IL 60068-1143 | 2020-09-10 |
| 1962014183 | Eric Swanson | Nurse Anesthetist, Certified Registered | 1775 Dempster St, Park Ridge, IL 60068-1143 | 2020-08-19 |
| 1740804046 | Lauren Kay | Nurse Practitioner | 1775 Dempster St, Park Ridge, IL 60068-1143 | 2020-06-02 |
| 1326660234 | Kellyn Bailey | Occupational Therapist | 1775 Dempster St, Park Ridge, IL 60068-1143 | 2020-05-13 |
| 1659992964 | Emma Hogaboom | Physical Therapist | 1775 Dempster St, Park Ridge, IL 60068-1143 | 2020-04-28 |
| 1003436403 | Sandra Kroschel | Nurse's Aide | 1775 Dempster St, Park Ridge, IL 60068-1143 | 2020-04-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861010720 | Caitlin Marie Kompanowski | Dentist | 412 W. Talcott, Park Ridge, IL 60068 | 2020-07-08 |
| 1972142198 | Center for Authentic Living, Inc. | Counselor | 120 Main Street Suite 200, Park Ridge, IL 60068 | 2020-01-06 |
| 1306312152 | Maryann Almores Devilla | Physical Medicine & Rehabilitation | Sunrise Assisted Living, 1725 Ballard Road, Park Ridge, IL 60068 | 2018-10-19 |
| 1053808857 | Landon Ginsberg | Student in an Organized Health Care Education/Training Program | 1775 Ballard, Park Ridge, IL 60068 | 2018-04-17 |
| 1255828448 | Vera W Brink | Obstetrics & Gynecology | Parkside Professional Center, 1875 Dempster St., Ste. 330, Park Ridge, IL 60068 | 2018-04-13 |
| 1205367448 | Courtney Heim | Psychiatry & Neurology | 1875 W.dempster Street - Park Side Professional Center, Ste 470, Park Ridge, IL 60068 | 2017-03-21 |
| 1720521362 | Alexander Mylonas | Psychologist | 1400 Renaissance Dr Ste 401, Park Ridge, IL 60068 | 2016-11-30 |
| 1376090878 | Rebecca Rajasekhar | Audiologist | 1030 W. Higgins Rd., Audiology Room 6, Park Ridge, IL 60068 | 2016-09-01 |
| 1164818449 | Mohammad Taha Mustaf Taha Mustafa Sheikh | Student in an Organized Health Care Education/Training Program | 1550 North Northwest Highway Suite 107, L.m. Prasad, Md, Sc, Park Ridge, IL 60068 | 2015-04-13 |
| 1518397918 | Megan Roberts | Speech-Language Pathologist | 2240 Campus Dr., Evanston, IL 60068 | 2013-11-21 |
| Find all providers in zip 60068 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063732931 | Marianna Krive | Internal Medicine | 1875 W Dempster St Ste 555, Park Ridge, IL 60068-1188 | 2010-06-02 |
| 1588047245 | Abdelhadi Rifai | Internal Medicine | 1875 W Dempster St, Park Ridge, IL 60068 | 2015-06-30 |
| 1699169862 | Adib Chaus | Internal Medicine | 1775 Ballard Rd, Park Ridge, IL 60068 | 2015-03-25 |
| 1801930029 | Specialists In Cardiology, Ltd. | Internal Medicine | 1875 Dempster St Ste 210, Park Ridge, IL 60068-1126 | 2007-02-19 |
| 1679617872 | Edward Passen | Internal Medicine | 1775 Dempster St, Park Ridge, IL 60068 | 2007-02-19 |
| 1417025735 | Christopher Pavlovic | Internal Medicine | 1875 Dempster St, Suite 604, Park Ridge, IL 60068-1186 | 2006-12-04 |
| 1619042785 | Thomas Pavlovic | Internal Medicine | 1875 Dempster St, #604, Park Ridge, IL 60068-1186 | 2006-11-22 |
| 1851466932 | Thomas A Pavlovic Md Sc | Internal Medicine | 1875 Dempster St, #604, Park Ridge, IL 60068-1186 | 2006-11-22 |
| 1801809306 | Lutheran General Hospital | Internal Medicine | 1775 Dempster St, Park Ridge, IL 60068-1143 | 2006-08-14 |
| 1609890979 | Samuel I Goldstein | Internal Medicine | 1875 Dempster St, Suite 555, Park Ridge, IL 60068-1186 | 2006-07-27 |
| Find all providers in PARK RIDGE | ||||
| City | PARK RIDGE |
| Zip Code | 60068 |
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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.