DR. DAVID GERARD JAIMOVICH (NPI# 1073536678) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073536678 |
| Entity Type | Individual |
| Full Name | DR. DAVID GERARD JAIMOVICH |
| Credential | MD |
| Practice Address |
4440 W 95th St Oak Lawn IL 60453-2600 |
| Practice Telephone | 7086844537 |
| Practice Fax Number | 7086844712 |
| Mailing Telephone | 7086844537 |
| Mailing Fax Number | 7086844712 |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
IL | Allopathic & Osteopathic Physicians |
| Street Address |
4440 W 95TH ST |
| City | OAK LAWN |
| State | IL |
| Zip Code | 60453-2600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902805666 | Kenneth S. Toth | Anesthesiology | 4440 W 95th St, Oak Lawn, IL 60453-2600 | 2005-07-15 |
| 1821697392 | Marissa Vavra | Occupational Therapist | 4440 W 95th St, Oak Lawn, IL 60453-2600 | 2020-10-25 |
| 1215535638 | Jarrod Siek Georgacakis | Nurse Practitioner | 4440 W 95th St, Oak Lawn, IL 60453-2600 | 2020-10-16 |
| 1396350708 | Crystal Oehmen | Radiology | 4440 W 95th St, Oak Lawn, IL 60453-2600 | 2020-09-11 |
| 1255943999 | Kristen Michele Hill | Nurse Practitioner | 4440 W 95th St, Oak Lawn, IL 60453-2600 | 2020-08-22 |
| 1033735295 | Thomas Panicucci | Registered Nurse | 4440 W 95th St, Oak Lawn, IL 60453-2600 | 2020-06-23 |
| 1538785407 | Amanda Thompson | Nurse Practitioner | 4440 W 95th St, Oak Lawn, IL 60453-2600 | 2020-06-17 |
| 1508481250 | Amy Marie Fader | Student in an Organized Health Care Education/Training Program | 4440 W 95th St, Oak Lawn, IL 60453-2600 | 2020-06-09 |
| 1528680139 | Nader Hamzeh Darwish | Student in an Organized Health Care Education/Training Program | 4440 W 95th St, Oak Lawn, IL 60453-2600 | 2020-05-18 |
| 1003438920 | Anna Manilla | Speech-Language Pathologist | 4440 W 95th St, Oak Lawn, IL 60453-2600 | 2020-05-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659995231 | Natalia Zero | Student in an Organized Health Care Education/Training Program | 4440 W 95th St, Rm 131 North, Oak Lawn, IL 60453 | 2020-05-30 |
| 1114554300 | Sylvia Maria Chlebek | Student in an Organized Health Care Education/Training Program | Advocate Christ Medical Center 4440 W. 95th St., Rm 131 North, Oak Lawn, IL 60453 | 2020-03-26 |
| 1972066751 | Amanda Mroczek | Family Medicine | 9555 52nd Avenue, Suite F, Oak Lawn, IL 60453 | 2019-04-09 |
| 1013479955 | Leah Rae Prager | Physician Assistant | 4400 W. 95th St., Attn: Pediatric General Surgery, Oak Lawn, IL 60453 | 2019-04-01 |
| 1659833473 | Chelsea Sumida Gipson | Family Medicine | 9555 South 52nd Avenue, Suite F, Oak Lawn, IL 60453 | 2019-04-01 |
| 1518427418 | Robert Lindgren | Family Medicine | 9555 S. 52nd Ave., Suite F, Oak Lawn, IL 60453 | 2019-03-25 |
| 1154886695 | Stephanie Anne Comer | Social Worker | 10102 South Cicero Avenue, Suite C, Oak Lawn, IL 60453 | 2019-02-08 |
| 1700360070 | Brian L Lee | Counselor | 8938 S Ridgeland Avenue Suite 100, Oak Lawn, IL 60453 | 2018-09-21 |
| 1679085245 | International Dental of Oak Lawn | Clinic/Center | 9539 S Cicero Ave, Oak Lawn, IL 60453 | 2017-11-03 |
| 1124538301 | Kavitha Rajendran | Physician Assistant | 5851 W. 95th Street, Suite 300, Oak Lawn, IL 60453 | 2017-10-02 |
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| Taxonomy Code | 2080P0203X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Critical Care Medicine |
| A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447267497 | Enrique Guillermo Cifuentes | Pediatrics | 4440 W. 95th Street, Oak Lawn, IL 60453 | 2006-08-02 |
| 1083965008 | Sofia Padilla | Pediatrics | 4440 W 95th St, Oak Lawn, IL 60453-2600 | 2012-10-01 |
| 1295961746 | Midwest Pediatric Critical Care Associates, LLC | Pediatrics | 4440 W 95th St, Oak Lawn, IL 60453-2600 | 2009-06-10 |
| 1881731255 | Nagendra Polavarapu | Pediatrics | 4440 W. 95th Street, Oak Lawn, IL 60453 | 2007-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982150702 | Kayla Duvall | Pediatrics | 5841 S Maryland Ave # 1145, Chicago, IL 60637-1443 | 2016-08-31 |
| 1215304258 | Huda Adam | Pediatrics | 5706 S Blackstone Ave, Unit 1, Chicago, IL 60637-1824 | 2015-08-25 |
| 1699916932 | Deanna Marie Behrens | Pediatrics | 840 S. Wood, Department of Pediatrics, Uic, Chicago, IL 60612 | 2009-03-17 |
| 1326207663 | Lauren Elizabeth Marsillio | Pediatrics | 225 E Chicago Ave # 15-119d, Chicago, IL 60611-2991 | 2008-06-02 |
| 1376606491 | Pallavi P. Patwari | Pediatrics | 1620 W Harrison St, Suite 7 Kellogg, Chicago, IL 60612-3801 | 2006-12-19 |
| 1972665974 | Denise M. Goodman | Pediatrics | 2300 N Childrens Plz # 73, Chicago, IL 60614-3363 | 2006-12-15 |
| 1386659415 | Bharat K Kotadia | Pediatrics | 1822 Arlington Ln, Glendale Heights, IL 60139-1309 | 2006-07-29 |
| 1447271911 | Mary Christine Baldauf | Pediatrics | 2400 N Rockten Ave, Rockford Health Physicians, Rockford, IL 61103-3619 | 2006-07-21 |
| 1407897887 | Rachel K Wolfson | Pediatrics | 5839 S Maryland Ave, Mc 4064, Chicago, IL 60637-1463 | 2006-06-09 |
| 1992770291 | Anwarul Haque | Pediatrics | Dept of Pediatric Critical Care, 530 Ne Glen Oak, Peoria, IL 61637-0001 | 2006-02-21 |
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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.