DR. CLYDE WHITING (NPI# 1073883203) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073883203 |
| Entity Type | Individual |
| Full Name | DR. CLYDE WHITING |
| Credential | M.D. |
| Practice Address |
1501 S California Ave Chicago IL 60608-1732 |
| Mailing Address |
8336 S Hermitage Ave Chicago IL 60620-4629 |
| Practice Telephone | 7732576097 |
| Mailing Telephone | 3129336075 |
| Enumeration Date | 2012-01-04 |
| Last Update Date | 2012-01-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
036129320 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
1501 S CALIFORNIA AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60608-1732 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033118856 | Robert C Parker | Internal Medicine | 1501 S California Ave, Chicago, IL 60608-1732 | 2005-07-14 |
| 1568094803 | Klaudia Magdalena Gwozdz | Nurse Practitioner | 1501 S California Ave, Chicago, IL 60608-1732 | 2020-02-05 |
| 1578036422 | Britney Kummerer | Social Worker | 1501 S California Ave, Chicago, IL 60608-1732 | 2019-01-03 |
| 1114405164 | Katya Tapia | Nurse Practitioner | 1501 S California Ave, Chicago, IL 60608-1732 | 2018-08-01 |
| 1487140166 | Rayman Johal | Family Medicine | 1501 S California Ave, Chicago, IL 60608-1732 | 2018-07-06 |
| 1871092940 | Maruf Yinusa | Nurse Practitioner | 1501 S California Ave, Chicago, IL 60608-1732 | 2018-02-05 |
| 1114456134 | Joanna Villacorta Griffin | Social Worker | 1501 S California Ave, Chicago, IL 60608-1732 | 2017-06-05 |
| 1982149159 | Carmen Murillo | Nurse Practitioner | 1501 S California Ave, Chicago, IL 60608-1732 | 2016-12-27 |
| 1558819821 | Man Ye | Physician Assistant | 1501 S California Ave, Chicago, IL 60608-1732 | 2016-09-15 |
| 1285180430 | Emily Arlene Grace | Physician Assistant | 1501 S California Ave, Chicago, IL 60608-1732 | 2016-08-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699390047 | Bethuna Shields | Occupational Therapist | 1401 South California Ave, Chicago, IL 60608 | 2020-06-11 |
| 1861024176 | Mount Sinai Community Foundation | Clinic/Center | 1414 S Fairfield, Chicago, IL 60608 | 2020-02-05 |
| 1205481058 | Joshua Hartman | Pharmacist | 345 Csb Mc 884, 840 S. Wood St, Chicago, IL 60608 | 2019-08-08 |
| 1194386706 | Mount Sinai Hospital, Chicago | Internal Medicine | Mount Sinai Hospital, 1500 S Fairfield Ave, Chicago, IL 60608 | 2019-06-25 |
| 1841754256 | Julia Bates | Occupational Therapist | 1640 W. Roosevelt Rd., 415 Dhsp (mc 726), Chicago, IL 60608 | 2019-01-30 |
| 1194205781 | Anais J Robles | Contractor | 1626 S Allport St, Chicago, IL 60608 | 2018-08-14 |
| 1114412970 | Dmitri Zbarsky | Internal Medicine | 1500 South Fairfield Ave., F-914, Chicago, IL 60608 | 2018-06-25 |
| 1740773050 | Alexia Ilian Derma Salazar | Speech-Language Pathologist | 2301 W 19th St - 3rd Floor Rear, Chicago, IL 60608 | 2018-06-11 |
| 1912424730 | Pareen Modi | Pharmacist | 2539 South Western Avenue, Chicago, IL 60608 | 2017-08-23 |
| 1952824302 | Raquel Gonzalez Heredia | Surgery | 1500 South Fairfield Ave, Chicago, IL 60608 | 2017-07-18 |
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| Taxonomy Code | 207QS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sports Medicine |
| A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477734150 | Sashil Singh Kapur | Family Medicine | 415 N Lasalle Street, Suite 100, Chicago, IL 60654 | 2007-11-21 |
| 1750360434 | Trish L. Palmer | Family Medicine | 1611 W Harrison, Suite 400, Chicago, IL 60612 | 2006-01-11 |
| 1710160130 | Munoz M.d. and Cvengros M.d., S.c. | Family Medicine | 2800 N Sheridan Rd, Suite G2, Chicago, IL 60657-6156 | 2007-12-07 |
| 1639390230 | Sara Ann Brown | Family Medicine | 711 W North Ave, Suite 202, Chicago, IL 60610-1174 | 2007-05-01 |
| 1750431870 | Daniel Thomas Davison | Family Medicine | 6500 W 65th St, Chicago, IL 60638-4962 | 2007-01-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164817334 | Shachi Pandya | Family Medicine | 18350 Kedzie Ave Ste 101, Homewood, IL 60430 | 2015-04-03 |
| 1821438185 | Marianne Hana | Family Medicine | 60 Orland Square Dr Ste 101, Orland Park, IL 60462 | 2013-07-01 |
| 1376894501 | Rush-copley Medical Group | Family Medicine | 2040 Ogden Ave., Suite 304, Aurora, IL 60504 | 2012-09-27 |
| 1144495961 | Karsten B Slater | Family Medicine | 1527 College Dr, Mount Carmel, IL 62863 | 2008-04-23 |
| 1104000561 | Competitive Edge Sports Medicine | Family Medicine | 14160 Jamestown Rd, Breese, IL 62230 | 2007-12-20 |
| 1659562585 | Ketan R Mody | Family Medicine | 760 Pasquinelli Dr Ste 304, Westmont, IL 60559-1290 | 2007-08-06 |
| 1285841544 | Arthur Aragones | Family Medicine | 135 E Irving Park Rd, Streamwood, IL 60107-2950 | 2007-05-17 |
| 1003028150 | Jill Wirth-rissman | Family Medicine | 205 N Cummings Ln, Washington, IL 61571-2181 | 2007-05-03 |
| 1497838676 | Christopher Eric Cieurzo | Family Medicine | 510 Pow Mia St Bldg P40, Scott Afb, IL 62225-5020 | 2006-10-23 |
| 1699861682 | Lawrence Timothy Kacmar | Family Medicine | 3965 75th St, Suite 103, Aurora, IL 60504-7925 | 2006-10-05 |
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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.