DR. JOSEPH PATRICK COSTELLO III (NPI# 1073607651) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073607651 |
| Entity Type | Individual |
| Full Name | DR. JOSEPH PATRICK COSTELLO III |
| Other Name | DR. JOSEPH P COSTELLO III |
| Credential | MD |
| Practice Address |
4212 N Illinois St Swansea IL 62226-1835 |
| Mailing Address |
Po Box 217 O Fallon IL 62269-0217 |
| Practice Telephone | 6182336685 |
| Practice Fax Number | 6182336616 |
| Mailing Telephone | 6182336685 |
| Mailing Fax Number | 6182336616 |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2011-11-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 036079559 | IL | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | FEDERAL TAX ID | 371390565 | 01 |
| IL | FEDERAL TAX ID | 432064512 | 01 |
| IL | O36079559 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245573682 | Joseph Thomas Costello | Psychologist | 50 Sequams Ln W, West Islip, NY 11795-4527 | 2013-04-04 |
| 1255644787 | Joseph Kennedy Costello Iv | General Practice | 224 N. 49th St. #4a, Omaha, NE 68132 | 2010-07-26 |
| 1821125527 | Joseph Costello | Pharmacist | 2577 Dolly Bay Dr, Unit 308, Palm Harbor, FL 34684-1136 | 2007-02-28 |
| 1578163598 | Joseph Anthony Costello IIi | Behavior Technician | 100 N Staebler Rd Ste A-b, Ann Arbor, MI 48103-9755 | 2020-10-28 |
| 1578160982 | Joseph C Costello | Pharmacist | 1325 Spring St, Greenwood, SC 29646-3860 | 2020-10-08 |
| 1639506017 | Joseph Patrick Costello | Physical Therapist | 57 W 57th St Fl 15, New York, NY 10019-2832 | 2013-10-01 |
| 1952613671 | Joseph M Costello | Podiatrist | 2121 N Baltimore St, Kirksville, MO 63501-5110 | 2010-07-10 |
| 1508004813 | Joseph T Costello | Physician Assistant | 650 Joel Drive, Blanchfield Army Community Hospital, Fort Campbell, KY 42223-5349 | 2009-01-23 |
| 1992979710 | Joseph Costello | Massage Therapist | 2935 Baseline Rd Ste 300, Boulder, CO 80303-2367 | 2008-04-14 |
| 1639148216 | Joseph J. Costello | Podiatrist | 45 N Main St, Suite 1, Pittston, PA 18640-1915 | 2006-03-16 |
| Street Address |
4212 N ILLINOIS ST |
| City | SWANSEA |
| State | IL |
| Zip Code | 62226-1835 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003052028 | Coskids Pediatrics Ltd | Pediatrics | 4212 N Illinois St, Swansea, IL 62226-1835 | 2008-12-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639778160 | Roxanna Lee Gunnels | Nurse Practitioner | 1 Bronze Pointe Plaza Suite 1a, Swansea, IL 62226 | 2020-10-26 |
| 1053969790 | Consistent Medical Transportation | Driver | 2012 N 17th St, Swansea, IL 62226 | 2019-08-27 |
| 1497314371 | Medi-plex Hospice of Illinois, LLC | Registered Nurse | 8 Park Place, Suite #3, Swansea, IL 62226 | 2019-06-13 |
| 1336617364 | Nicole Renee Schmidt | Speech-Language Pathologist | 150 N 27th St., Belleville, IL 62226 | 2018-11-07 |
| 1295258903 | Catherine Espino | Pharmacist | 11 Chambers Blvd, Swansea, IL 62226 | 2017-07-25 |
| 1366806838 | Kiley Faires | Nurse Practitioner | 4600 Memorial Drive Ste 360, Belleville, IL 62226 | 2016-04-11 |
| 1760857585 | Mvp Transportation | Non-emergency Medical Transport (VAN) | 1229 N 17th Street, Number 23, Belleville, IL 62226 | 2015-12-04 |
| 1275952566 | Aisha Danyale Franklin | Internal Medicine | 4261 Woodfield Pl, Belleville, IL 62226 | 2014-04-15 |
| 1396168332 | Jayne E. Ninness | Physical Therapy Assistant | 4500 Memorial Dr., Memorial Hospital, Belleville, IL 62226 | 2014-01-28 |
| 1053758193 | Gateway Foundation, Inc. | Clinic/Center | 1 Bronze Point, Suite 1, Swansea, IL 62226 | 2013-05-30 |
| Find all providers in zip 62226 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063710333 | Chelsea Kopacz | Specialist | 51 Anthony Ave, Swansea, MA 02777-2206 | 2011-03-10 |
| 1578773453 | Gloria L Bajor | Specialist | 90 Barneyville Rd, Swansea, MA 02777-3302 | 2007-05-22 |
| 1275965501 | Joanne D Degiacomo | Specialist | 463 Swansea Mall Dr, Swansea, MA 02777-4119 | 2013-08-09 |
| 1235467606 | Associated Physicians Group Ltd | Specialist | 12 Wolf Creek Dr, Suite 200, Swansea, IL 62226-2314 | 2009-11-24 |
| 1750511242 | Melissa Schleeper Kiel | Specialist | 3990 N Illinois St, Swansea, IL 62226-1919 | 2009-07-20 |
| 1851327878 | Southwest Illinois Health Services, LLP | Specialist | 4000 North Illinois, Suite B, Swansea, IL 62226-1946 | 2006-06-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447850730 | Nirvana Medspa and Laser Center, Ltd | Specialist | 11801 Southwest Hwy Ste 2n, Palos Heights, IL 60463-1069 | 2020-10-27 |
| 1801402938 | Terri Sendelbach | Specialist | 340 W Butterfield Rd Ste 4b-418, Elmhurst, IL 60126-5069 | 2020-09-23 |
| 1346899630 | Jeremy Gantz Morse | Specialist | 815 W Buena Ave, Chicago, IL 60613-1694 | 2019-09-09 |
| 1619539632 | Benjamin Mendoza | Specialist | 6303 W 63rd St Unit 3c, Chicago, IL 60638-7015 | 2019-06-29 |
| 1891356176 | Kristin Michelle Stahlheber | Specialist | 6718 Goshen Rd, Edwardsville, IL 62025-3025 | 2019-06-26 |
| 1689238438 | Sara Sladoje | Specialist | 936 Raleigh Rd, Glenview, IL 60025-4330 | 2019-04-26 |
| 1760940100 | Eqmd, Inc. | Specialist | 1800 Nations Dr Ste 216, Gurnee, IL 60031-9174 | 2019-03-05 |
| 1962979286 | Time 2 Talk, LLC | Specialist | 6791 Wesley Chapel Rd, Chatham, IL 62629-9722 | 2018-10-24 |
| 1871068783 | Kelsey Lynn Mora | Specialist | 5225 Old Orchard Rd Ste 14, Skokie, IL 60077-1027 | 2018-10-06 |
| 1811471808 | Judith M Penn | Specialist | 8312 S Kedzie Ave, Chicago, IL 60652-3309 | 2018-09-17 |
| Find all providers with the same taxonomy | ||||
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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.