ADVOCATE ILLINOIS MASONIC MEDICAL CENTER (NPI# 1114189255) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114189255 |
| Entity Type | Organization |
| Organization Name | ADVOCATE ILLINOIS MASONIC MEDICAL CENTER |
| Practice Address |
3048 N Wilton Ave Fl 2 Chicago IL 60657-6710 |
| Mailing Address |
836 W Wellington Ave Rm 7403 Chicago IL 60657-5147 |
| Practice Telephone | 7732965424 |
| Practice Fax Number | 7732965280 |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2008-06-30 |
| Authorized Official Name | DR. TERESA RAMOS (RESIDENCY PROGRAM DIRECTOR) |
| Authorized Official Telephone | 7732967046 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | ADVOCATE HEALTH CARE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 125054918 | IL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104062462 | Advocate Illinois Masonic Medical Center | General Acute Care Hospital | 3632 Wirth Rd, Highland, IN 46322-2218 | 2008-12-16 |
| 1881915585 | Advocate Illinois Masonic Medical Center | General Acute Care Hospital | 836 W Wellington Ave, Chicago, IL 60657-5147 | 2010-06-16 |
| 1558510388 | Advocate Illinois Masonic Medical Center | Internal Medicine | 836 W Wellington Ave, Chicago, IL 60657-5147 | 2008-09-17 |
| 1558517714 | Advocate Illinois Masonic Medical Center | Internal Medicine | 3048 N Wilton Ave, 2nd Floor, Chicago, IL 60657-6710 | 2008-08-07 |
| 1750537916 | Advocate Illinois Masonic Medical Center | Internal Medicine | 3048 N Wilton Ave, 2nd Floor, Chicago, IL 60657-6710 | 2008-08-07 |
| 1508021098 | Advocate Illinois Masonic Medical Center | Internal Medicine | 836 W Wellington, Chicago, IL 60657 | 2008-07-23 |
| 1316114937 | Advocate Illinois Masonic Medical Center | Internal Medicine | 836 W Wellington Ave, Room 7403, Chicago, IL 60657-5147 | 2008-05-13 |
| 1881861490 | Advocate Illinois Masonic Medical Center | Internal Medicine | 836 W Wellington Ave, Chicago, IL 60657-5147 | 2008-05-13 |
| 1063688786 | Advocate Illinois Masonic Medical Center | Internal Medicine | 3048 N Wilton Ave Fl 2, Chicago, IL 60657-6710 | 2008-05-02 |
| 1326214040 | Advocate Illinois Masonic Medical Center | Internal Medicine | 3048 N Wilton Ave, 2nd Floor, Chicago, IL 60657-6710 | 2008-05-02 |
| Street Address |
3048 N WILTON AVE FL 2 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60657-6710 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558391581 | Laura Lee Concannon | Internal Medicine | 3048 N Wilton Ave Fl 2, Chicago, IL 60657-6710 | 2006-07-04 |
| 1972088615 | Heartland International Health Center | Case Management | 3048 N Wilton Ave Fl 2, Chicago, IL 60657-6710 | 2018-09-28 |
| 1063688786 | Advocate Illinois Masonic Medical Center | Internal Medicine | 3048 N Wilton Ave Fl 2, Chicago, IL 60657-6710 | 2008-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992303887 | Simone Paes | Behavior Technician | 3141 N Sheffield Ave, Chicago, IL 60657 | 2020-10-13 |
| 1821613175 | Samridhi Khatri | Internal Medicine | 836 W. Wellington Ave, Advocate Illinois Masonic Medica, Suite 1312, Chigaco, IL 60657 | 2020-06-12 |
| 1467074617 | Dewolfe Aesthetic Services Sc | Surgery | 3357 N. Southport Aveune, Chicago, IL 60657 | 2020-05-11 |
| 1790304657 | Mehr Amer Mjeed | Student in an Organized Health Care Education/Training Program | Advocate Internal Medicine Clinic, Advocate Illinois Ma, 836 West Wellington Avenue, Chicago, IL 60657 | 2020-04-10 |
| 1457997561 | Jasleen Mohini Singh | Physician Assistant | 1645a W School Street, Suite A, Clinic Entrance, Chicago, IL 60657 | 2019-11-24 |
| 1306493408 | Art of Sight Eyecare, LLC | Optometrist | 2915 N. Broadway, Chicago, IL 60657 | 2019-08-22 |
| 1992359277 | Joseph Michael Rochford IIi | Counselor | 1358 W Belmont Ave, Unit # 202, Chicago, IL 60657 | 2019-07-25 |
| 1487116240 | Conrad Petersen Dermatology Sc | Dermatology | 2845 N Sheridan, Chicago, IL 60657 | 2019-04-02 |
| 1003388810 | Evolve Wellness S.c. | Counselor | 2845 North Sheridan Road, Suite 708, Chicago, IL 60657 | 2018-12-19 |
| 1639657414 | Advocate North Side Health Network | Psychiatric Unit | 836 W Wellington Ave., Chicago, IL 60657 | 2018-08-02 |
| Find all providers in zip 60657 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| 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 Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922606193 | Thatiana Carolina Schulze Goni | Internal Medicine | 5924 N Lincoln Ave Apt 205, Chicago, IL 60659-3736 | 2020-10-11 |
| 1750995742 | Eva Bartaula | Internal Medicine | 1500 S Fairfield Ave # 3, Chicago, IL 60608-1782 | 2020-09-07 |
| 1750994513 | Ranjit Babu Jasaraj | Internal Medicine | 1500 S Fairfield Ave # F-914, Chicago, IL 60608-1782 | 2020-08-30 |
| 1871106005 | Vijay Ketan Reddy | Internal Medicine | 1500 S Fairfield Ave Dept Roomf914, Chicago, IL 60608-1782 | 2020-08-27 |
| 1144839739 | Sandhya Shri Kannayiram | Internal Medicine | 1901w Harrison Street, Chicago, IL 60612 | 2020-07-29 |
| 1871119172 | Irina Komissarova | Internal Medicine | 916 S Oakley Blvd, Chicago, IL 60612-4230 | 2020-06-22 |
| 1336760719 | Arslan Zahid | Internal Medicine | 5847 S Maryland Ave, Chicago, IL 60637-1463 | 2020-04-27 |
| 1104447572 | Nirmal Desai | Internal Medicine | 5841 S Maryland Ave., M/c 7082, Chicago, IL 60637-1443 | 2020-04-27 |
| 1467072447 | Justin Edmond Sipiora | Internal Medicine | 5841 S. Maryland Ave Mc 7082, Chicago, IL 60637-1443 | 2020-04-20 |
| 1003449612 | Eoht LLC | Internal Medicine | 1718 W North Shore Ave Apt 11, Chicago, IL 60626-4030 | 2020-02-21 |
| Find all providers in CHICAGO | ||||
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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.