SUBURBAN GYNECOLOGY, LLC (NPI# 1063602217) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063602217 |
| Entity Type | Organization |
| Organization Name | SUBURBAN GYNECOLOGY, LLC |
| Other Organization Name | SUBURBAN OBSTETRICS & GYNECOLOGY, LLC. |
| Practice Address |
1301 Copperfield Avenue Suite 113 Joliet IL 60432-2004 |
| Mailing Address |
1890 Silver Cross Blvd Suite #375 New Lenox IL 60451 |
| Practice Telephone | 8157277515 |
| Practice Fax Number | 8157275147 |
| Mailing Telephone | 8157178727 |
| Mailing Fax Number | 8157178722 |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2012-02-08 |
| Authorized Official Name | NAHLA MERHI (PROVIDER) |
| Authorized Official Telephone | 8156851971 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207V00000X | Obstetrics & Gynecology | 036107262 | IL | Allopathic & Osteopathic Physicians |
| Y | 207V00000X | Obstetrics & Gynecology | 036-107262 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036107262 | 05 | |
| IL | CLIA | 14D1089841 | 01 |
| Other Name | Type Code |
|---|---|
| Suburban Obstetrics & Gynecology, LLC. | Former Legal Business Name - Organization |
| Street Address |
1301 COPPERFIELD AVENUE SUITE 113 |
| City | JOLIET |
| State | IL |
| Zip Code | 60432-2004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366501835 | Health Care Delivery Systems | Internal Medicine | 1301 Copperfield Avenue, Suite 202, Joliet, IL 60432 | 2006-12-08 |
| 1174809503 | Aunt Martha's Youth Service Center Inc | Clinic/Center | 1301 Copperfield Avenue, Suite 201, Joliet, IL 60432-2056 | 2011-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053830943 | Abilio Milo | General Practice | 213 East Cass Street, Joliet, IL 60432 | 2017-09-12 |
| 1508284258 | Allison R. Nichols | Social Worker | 62 W. Washington St., Joliet, IL 60432 | 2014-03-31 |
| 1073950044 | Aunt Martha's Youth Service Center, Inc | Clinic/Center | 1200 Eagle Street, Joliet, IL 60432 | 2013-05-30 |
| 1124388624 | Fresenius Medical Care of Plainfield, LLC | Clinic/Center | 721 E Jackson St., Joliet, IL 60432 | 2012-05-18 |
| 1730375833 | Rhonda Denise Posley | Licensed Practical Nurse | 215 Clinton, Suite B, Joliet, IL 60432 | 2007-09-21 |
| 1538385463 | Frank C Bender | Family Medicine | 213 E Cass St, Joliet, IL 60432 | 2007-04-18 |
| 1134294614 | Mary Lee Johnson | Counselor | 62 West Washington Street, Joliet, IL 60432 | 2006-11-21 |
| 1609953223 | Catholic Charities of The Diocese of Joliet | Community/Behavioral Health | 58 E Clinton St Ste 200, Joliet, IL 60432 | 2006-11-01 |
| 1487740932 | Carlla Duster Franklin | Dentist | 2241 Theodore Street, Crest Hill, IL 60432 | 2006-10-04 |
| 1558478883 | Mary Alice Spinabella | Social Worker | 62 West Washington, Joliet, IL 60432 | 2006-08-24 |
| Find all providers in zip 60432 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114080033 | Angela Intili | Obstetrics & Gynecology | 1415 Essington Rd, Joliet, IL 60435-2873 | 2006-12-19 |
| 1356373120 | Casey A Moauro | Obstetrics & Gynecology | 201 N Hammes Ave, Joliet, IL 60435 | 2006-07-06 |
| 1447247424 | Francis G Tomasik | Obstetrics & Gynecology | 3077 W Jefferson St, Suite 101, Joliet, IL 60435-5262 | 2005-10-04 |
| 1487050654 | Pranjali Vadgaonkar | Obstetrics & Gynecology | 1106 Neal Ave, Joliet, IL 60433-2548 | 2014-11-14 |
| 1841562881 | Kanchana Esairya-umpai M D S C | Obstetrics & Gynecology | 1026 Essington Rd, Joliet, IL 60435-2841 | 2012-02-07 |
| 1245410315 | Angela Intili Md Ltd | Obstetrics & Gynecology | 1415 Essington Rd, Joliet, IL 60435-2873 | 2007-11-06 |
| 1821116468 | K A Boateng Md Facog PC | Obstetrics & Gynecology | 2000 Glenwood Ave, Lower Level East, Joliet, IL 60435-5676 | 2007-03-26 |
| 1467579789 | Joliet Womens Health Center | Obstetrics & Gynecology | 201 N Hammes Ave, Joliet, IL 60435-6611 | 2007-03-23 |
| 1982744363 | Daniel Lee Beck | Obstetrics & Gynecology | 310 N Hammes Ave, Suite 201, Joliet, IL 60435-8118 | 2007-02-07 |
| 1467540542 | Ion Dumitru | Obstetrics & Gynecology | 1106 Neal Ave, Joliet, IL 60433-2548 | 2006-10-11 |
| Find all providers in JOLIET | ||||
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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.