DR. ABRAHAM FONTANILLA (NPI# 1104975978) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104975978 |
| Entity Type | Individual |
| Full Name | DR. ABRAHAM FONTANILLA |
| Credential | M.D. |
| Practice Address |
200 Laird Ln Watseka IL 60970-7568 |
| Mailing Address |
200 E Fairman Ave Watseka IL 60970-1644 |
| Practice Telephone | 8154325411 |
| Practice Fax Number | 8154323955 |
| Mailing Telephone | 8154325841 |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2013-03-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 036126637 | IL | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | 01037991 | IN | Allopathic & Osteopathic Physicians |
| Street Address |
200 LAIRD LN |
| City | WATSEKA |
| State | IL |
| Zip Code | 60970-7568 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366447617 | Iroquois Memorial Hospital and Resident Home | Home Health | 200 Laird Ln, Watseka, IL 60970-7568 | 2005-06-14 |
| 1447610472 | Iroquois Memorial Hospital and Resident Home | Clinic/Center | 200 Laird Ln, Watseka, IL 60970-7568 | 2016-03-03 |
| 1851721948 | Janella Schroeder | Nurse Practitioner | 200 Laird Ln, Watseka, IL 60970-7568 | 2013-11-26 |
| 1497097679 | Cristiane White | Speech-Language Pathologist | 200 Laird Ln, Watseka, IL 60970-7568 | 2013-03-26 |
| 1851641138 | Kristy M Huse | Occupational Therapist | 200 Laird Ln, Watseka, IL 60970-7568 | 2012-09-14 |
| 1588914782 | William S. Cooke | Physical Therapist | 200 Laird Ln, Watseka, IL 60970-7568 | 2012-09-14 |
| 1134445851 | Iroquois Memorial Hospital | General Practice | 200 Laird Ln, Watseka, IL 60970-7568 | 2010-04-20 |
| 1376876250 | Optech Orthotics & Prosthetics, Inc. | Prosthetic/Orthotic Supplier | 200 Laird Ln, Watseka, IL 60970-7568 | 2009-09-10 |
| 1114076080 | Angelita Fontanilla | Pediatrics | 200 Laird Ln, Watseka, IL 60970-7568 | 2007-01-09 |
| 1790889194 | Iroquois Memorial Hospital and Resident Home | Family Medicine | 200 Laird Ln, Watseka, IL 60970-7568 | 2006-09-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376189167 | Malinda S Mustered | Occupational Therapist | 825 S Belmont Ave, Watseka, IL 60970 | 2019-11-27 |
| 1558889188 | K-shayla Lafayette | Nurse Practitioner | 200 E. Fairman Ave., Watseka, IL 60970 | 2017-09-04 |
| 1144354879 | Pamela H. Beall | Counselor | 1801 N. State Route 1, Suite 2, Watseka, IL 60970 | 2007-03-15 |
| 1528111879 | Spine Clinics of America Sc | Chiropractor | 425 E. Walnut Street, Watseka, IL 60970 | 2007-01-19 |
| 1699833970 | Shakeel Sher Khan Sandozi | Surgery | 625 S Fifth Street, Watseka, IL 60970 | 2006-12-05 |
| 1790859866 | David Charles Nagele | Dentist | 130 N Littelfuse Ln, Suite 101, Watseka, IL 60970 | 2006-11-20 |
| 1942389259 | John M Rose | Dentist | 316 E Lincoln Ave, Watseka, IL 60970 | 2006-11-06 |
| 1952324279 | Bonita Jean Rajala | Counselor | 617 East Grant St., Watseka, IL 60970 | 2006-07-26 |
| 1396978177 | Allison Shindelar | Social Worker | 323 Wmulberry St, Watseka, IL 60970-0332 | 2009-08-27 |
| 1356441539 | Petersen Health Operations, LLC | Skilled Nursing Facility | 900 N Market St, Watseka, IL 60970-1048 | 2006-09-25 |
| Find all providers in zip 60970 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699833970 | Shakeel Sher Khan Sandozi | Surgery | 625 S Fifth Street, Watseka, IL 60970 | 2006-12-05 |
| 1083066674 | Iroquois Memorial Hospital | Surgery | 200 E Fairman Ave, Watseka, IL 60970-1644 | 2016-07-07 |
| 1598081218 | Iroquois Memorial Hospital | Surgery | 625 S 5th St, Watseka, IL 60970-1835 | 2010-04-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003430166 | Conlan Joseph Pierce | Surgery | 601 W Park St, Urbana, IL 61801 | 2020-06-04 |
| 1376167809 | Francesco Bajani | Surgery | 664 N Dearborn St Apt 2f, Chicago, IL 60654-3848 | 2020-06-01 |
| 1972123099 | Andrea Liu | Surgery | 5841 S Maryland Ave Mc6040, Chicago, IL 60637-1443 | 2020-04-18 |
| 1750917183 | Alberto Maria Fratti | Surgery | 901 S Ashland Ave Apt 711, Chicago, IL 60607-4088 | 2020-03-17 |
| 1841845047 | Barijuve Surgical LLC | Surgery | 380 E Northwest Hwy Ste 200, Des Plaines, IL 60016-2274 | 2019-08-05 |
| 1164081782 | Sean Park | Surgery | 1739 Tudor Ln Unit 308, Northbrook, IL 60062-3778 | 2019-06-07 |
| 1376014175 | Edwardsville Physicians Group LLC | Surgery | 441 South State Route 157 Suite 102, Edwardsville, IL 62025-4012 | 2018-12-06 |
| 1316421324 | Erica Lester | Surgery | John H Stroger, 1969 Ogden Ave, Chicago, IL 60612 | 2018-09-17 |
| 1023513389 | Crystal Siyu Zhang | Surgery | 2160 S 1st Ave Bldg 3210, Maywood, IL 60153 | 2018-03-28 |
| 1376047381 | Richard Lawrence Nelson | Surgery | 1603 W. Taylor St., Room 983, Chicago, IL 60612-4394 | 2018-03-23 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. ABRAHAM FONTANILLA.
| 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.