ANTONIO DESEAN LOZADA (NPI# 1053677047) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053677047 |
| Entity Type | Individual |
| Full Name | ANTONIO DESEAN LOZADA |
| Practice Address |
305 W Jackson St Ste 302 Carbondale IL 62901 |
| Mailing Address |
305 W Jackson St Ste 302 Carbondale IL 62901-1474 |
| Practice Telephone | 6184575200 |
| Practice Fax Number | 6184573007 |
| Mailing Telephone | 9135886101 |
| Mailing Fax Number | 9135887540 |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2019-10-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0127X |
Surgery Specialization: Trauma Surgery |
036145468 | IL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407041734 | Antonio Lozada | Internal Medicine | 227 Caguas Real, Caguas, PR 00725 | 2007-09-10 |
| Street Address |
305 W JACKSON ST STE 302 |
| City | CARBONDALE |
| State | IL |
| Zip Code | 62901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518998202 | Christopher Taro Hogg | Orthopaedic Surgery | 305 W Jackson St Ste 302, Carbondale, IL 62901 | 2006-07-05 |
| 1720368145 | Aela Pauline Diane C Vely | Surgery | 305 W Jackson St Ste 302, Carbondale, IL 62901 | 2011-08-17 |
| 1235447368 | Kulsoom Laeeq | Surgery | 305 W Jackson St Ste 302, Carbondale, IL 62901 | 2010-09-23 |
| 1295819381 | Kara Danielle Flatt | Nurse Practitioner | 305 W Jackson St Ste 302, Carbondale, IL 62901-1474 | 2006-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558961268 | Gerad Aaron Harsy | Pharmacist | Walmart Pharmcy, 1450 East Main St, Carbondale, IL 62901 | 2020-10-30 |
| 1437708674 | Board of Trustees of Southern Illinois University | Clinic/Center | 300 W Oak Street, Carbondale, IL 62901 | 2019-09-10 |
| 1306317383 | Rachael O Johnson | Nurse Practitioner | 404 S. Lewis Ln, Carbondale, IL 62901 | 2018-12-17 |
| 1740795194 | Megan Marie Zimmerman | Nurse Practitioner | 1100 W Diann Ln., Carbondale, IL 62901 | 2017-12-07 |
| 1295244242 | Amy Elizabeth Prudencio | Social Worker | 1301 E. Walnut Street, Carbondale, IL 62901 | 2017-09-21 |
| 1740708171 | Theresa Aleise Goodin | Speech-Language Pathologist | 1301 East Walnut Street, Carbondale, IL 62901 | 2017-09-06 |
| 1144762527 | Kathleen Chwalisz Rigney | Psychologist | 306 West Mill Street, Neurorestorative, Carbondale, IL 62901 | 2016-11-16 |
| 1285185173 | Shawnee Health Service and Development Corp | Social Worker | 404 S. Lewis Lane, Carbondale, IL 62901 | 2016-10-17 |
| 1437605094 | Arielle Greer | Nurse's Aide | 510 E. Russell St., A, Carbondale, IL 62901 | 2016-09-01 |
| 1518413863 | Complete Family Eyecare of Carbondale, PC | Optometrist | 1241 East Walnut Street, Carbondale, IL 62901 | 2016-08-28 |
| Find all providers in zip 62901 | ||||
| Taxonomy Code | 2086S0127X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Trauma Surgery |
| Trauma surgery is a recognized subspecialty of general surgery. Trauma surgeons are physicians who have completed a five-year general surgery residency and usually continue with a one to two year fellowship in trauma and/or surgical critical care, typically leading to additional board certification in surgical critical care. There is no trauma surgery board certification at this point. To obtain board certification in surgical critical care, a fellowship in surgical critical care or anesthesiology critical care must be completed during or after general surgery residency. |
| Notes: Source: American Board of Surgery, 2007 [1/1/2008: definition added, source added] Additional Resources: http://www.absurgery.org/. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467986901 | Congress Vein Clinic LLC | Surgery | 41 W Congress Pkwy, 1st Floor, Chicago, IL 60605-1531 | 2017-04-11 |
| 1124029095 | Gary J Merlotti | Surgery | 840 S Wood Street, Csb - Mc 958 - Ste 616, Chicago, IL 60612 | 2005-08-02 |
| 1457357592 | Michael J Kikta | Surgery | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2005-06-23 |
| 1467067942 | Francesca Bryan | Surgery | 1950 W Polk St Ste 5210, Chicago, IL 60612-3723 | 2020-09-11 |
| 1528486032 | Jacqueline Ann Kalmoe | Surgery | 9650 Gross Point Rd Ste 3900, Skokie, IL 60076-5085 | 2014-04-01 |
| 1467713248 | Jacob Baruch Avraham | Surgery | 9650 Gross Point Rd Ste 3900, Skokie, IL 60076-5085 | 2012-06-07 |
| 1548579576 | West Suburban Surgical, S.c. | Surgery | 1315 N Highland Ave, Suite 203, Aurora, IL 60506-1400 | 2010-09-24 |
| 1740514140 | Emergency Surgical Services of Lake County LLC | Surgery | 1870 W Winchester Rd, Suite 112, Libertyville, IL 60048-5358 | 2009-10-01 |
| 1124255856 | Michael James Anstadt | Surgery | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2009-06-21 |
| 1730341553 | Yuk Ming Liu | Surgery | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2008-07-02 |
| Find all providers with the same taxonomy | ||||
| City | CARBONDALE |
| Zip Code | 62901 |
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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.